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Ipilimumab and radiation therapy for melanoma brain metastases
dc.contributor.authorSilk, Ann W.en_US
dc.contributor.authorBassetti, Michael F.en_US
dc.contributor.authorWest, Brady T.en_US
dc.contributor.authorTsien, Christina I.en_US
dc.contributor.authorLao, Christopher D.en_US
dc.date.accessioned2013-12-04T18:58:07Z
dc.date.available2015-01-05T13:54:43Zen_US
dc.date.issued2013-12en_US
dc.identifier.citationSilk, Ann W.; Bassetti, Michael F.; West, Brady T.; Tsien, Christina I.; Lao, Christopher D. (2013). "Ipilimumab and radiation therapy for melanoma brain metastases." Cancer Medicine 2(6): 899-906.en_US
dc.identifier.issn2045-7634en_US
dc.identifier.issn2045-7634en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/101868
dc.description.abstractIpilimumab, an antibody that enhances T‐cell activation, may augment immunogenicity of tumor cells that are injured by radiation therapy. We hypothesized that patients with melanoma brain metastasis treated with both ipilimumab and radiotherapy would have improved overall survival, and that the sequence of treatments may affect disease control in the brain. We analyzed the clinical and radiographic records of melanoma patients with brain metastases who were treated with whole brain radiation therapy or stereotactic radiosurgery between 2005 and 2012. The hazard ratios for survival were estimated to assess outcomes as a function of ipilimumab use and radiation type. Seventy patients were identified, 33 of whom received ipilimumab and 37 who did not. The patients who received ipilimumab had a censored median survival of 18.3 months (95% confidence interval 8.1–25.5), compared with 5.3 months (95% confidence interval 4.0–7.6) for patients who did not receive ipilimumab. Ipilimumab and stereotactic radiosurgery were each significant predictors of improved overall survival (hazard ratio = 0.43 and 0.45, with P  = 0.005 and 0.008, respectively). Four of 10 evaluable patients (40.0%) who received ipilimumab prior to radiotherapy demonstrated a partial response to radiotherapy, compared with two of 22 evaluable patients (9.1%) who did not receive ipilimumab. Ipilimumab is associated with a significantly reduced risk of death in patients with melanoma brain metastases who underwent radiotherapy, and this finding supports the need for multimodality therapy to optimize patient outcomes. Prospective studies are needed and are underway. Treatment with ipilimumab significantly reduced the risk of death by 57% in patients with brain metastases due to melanoma who underwent whole brain radiation therapy or stereotactic radiosurgery ( SRS ). Patients who were treated with SRS and ipilimumab had a 16‐month improvement in survival as compared to those who received SRS alone.en_US
dc.publisherStata Pressen_US
dc.publisherWiley Periodicals, Inc.en_US
dc.subject.otherMelanomaen_US
dc.subject.otherIpilimumaben_US
dc.subject.otherStereotactic Radiosurgeryen_US
dc.subject.otherImmunotherapyen_US
dc.subject.otherBrain Metastasesen_US
dc.titleIpilimumab and radiation therapy for melanoma brain metastasesen_US
dc.typeArticleen_US
dc.rights.robotsIndexNoFollowen_US
dc.subject.hlbsecondlevelHematology and Oncologyen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/101868/1/cam4140.pdf
dc.identifier.doi10.1002/cam4.140en_US
dc.identifier.sourceCancer Medicineen_US
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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