During this season for skin cancer, ipilimumab (YEVOY, BMS) has been recommended for cost-sharing under the PBS for patients with unresectable or metastatic melanoma where effective therapies are not available.
Ipilimumab is a human monoclonal antibody that potentiates T-cell mediated immune responses by blocking the inhibition of T-cell activation, resulting in proliferation, and lymphocyte infiltration into tumours, leading to tumour cell death. Median overall survival for stable disease is 22 months, and 8 months for progressive disease, responses sometimes being observed up to 5.5 months from the start of therapy.
Patients should report any symptoms suggestive of inflammation from increased or excessive immune activity, which must be treated promptly to prevent life-threatening complications. Use in patients with renal or hepatic impairment has not been studied, and ipilimumab is not expected to have pharmacokinetic-based drug interactions.
Above 10% of patients report fatigue, diarrhoea, pruritus, rash, decreased appetite, vomiting, abdominal pain, cough, headache, pyrexia, and insomnia, and are sufficient to cause 10% of patients to cease ipilimumab.
The PBS also offers interferon alfa-2B as the only drug, until now, with demonstrated efficacy as adjuvant therapy for high-risk melanoma, although with substantial toxicity according to The Clinical Practice Guidelines for the Management of Melanoma.