Quick Facts About: Ipilimumab

Yervoy

Yes, in 2011.

Microsatellite instability-high (MSI-high) metastatic colorectal cancer.

Ipilimumab may also be used in treatment regimens for the following cancers:

• Cutaneous melanoma
• Metastatic and/or unresectable melanoma
• Advanced renal cell carcinoma
• Hepatocellular carcinoma
• Unresectable malignant pleural mesothelioma
• Metastatic non-small cell lung carcinoma

*All dosages indicated here are specific to colorectal cancer treatment.

Ipilmumab is administered intravenously.

Ipilmumab is administered in combination with nivolumab for patients whose cancer has progressed after treatment using fluoropyrimidine, oxaliplatin and irinotecan.

Dosage is dependent on drug combination in the treatment regimen and is based on the patient’s weight (milligram per kilogram, mg/kg).

1 mg/kg of ipilmumab is administered in combination with nivolumab every 3 weeks for 4 doses. Each dose is given via infusion over 30 minutes. After 4 doses, nivolumab is administered as monotherapy until disease progression or unacceptable toxicity levels are reached.

Ipilimumab should not be used in cases of severe active autoimmune disease, where further immune activation is potentially life-threatening, and in lactating patients.

Special precautions are needed for patients with

• History of
  • Severe skin-related adverse reactions to previous cancer immune response therapy
  • Autoimmune diseases
• Chronic infections, recurrent infections, or underlying conditions that increase infection risk
• Controlled myasthenia gravis (MG)
• Existing/previous brain or leptomeningeal metastases
• Pre-existing interstitial lung disease
• Conditions necessitating systemic immunosuppressive therapy
• Primitive peritoneal, pericardial, testis or tunica vaginalis mesothelioma
• Baseline transaminase levels greater than 5 times the upper limit of normal (ULN) or bilirubin levels greater than 3 times the ULN
• Patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT)
• Pregnancy

Potential side effects of ipilimumab specific to colorectal cancer treatment include:

• High blood pressure
• Numbness or tingling in hands or feet
• Increased risk of bruising, bleeding, and infection
• Fatigue, weakness, and lethargy
• Gastrointestinal symptoms like diarrhea, nausea, abdominal pain, and constipation
• Blood in stool
• Loss of appetite and weight
• Eye problems including teary eyes
• Vocal changes or hoarseness
• Taste bud changes
• Nosebleeds or a runny nose
• Protein in the urine
• Skin problems such as rash, dry skin, or itching
• Muscle and joint pain
• Headaches
• Slurred speech
• Cough or shortness of breath
• Mouth ulcers

Ipilimumab is a recombinant monoclonal antibody used in immunotherapy.

Ipilimumab specifically targets cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), which is known for down-regulating T-cell activation pathways.

In doing so, ipilimumab disrupts the interaction between CTLA-4 and its ligands. This action has the effect of boosting T-cell activation and proliferation, including an increase in the number of active T-effector cells. These cells play a vital role in launching a direct T-cell immune assault against cancerous cells. In addition, inhibiting CTLA-4 may reduce the functioning of T-regulatory cells, leading to heightened T-cell responsiveness, especially in mounting an anti-tumor immune response.