Ipilimumab administration for advanced melanoma in patients with pre-existing Hepatitis B or C infection: A multicenter, retrospective case series

• Authors: Sowmya Ravi, Johns Hopkins University; Kristen Spencer, Rutgers Cancer Institute of New Jersey; Mary Ruisi, Bristol-Myers Squibb; Nageatte Ibrahim, Harvard Medical School; Jason J. Luke, Harvard Medical School; John A. Thompson, University of Washington; Keisuke Shirai, Medical University of South Carolina; David Lawson, Emory University; Heddy Bartell, Bristol-Myers Squibb; Ragini Kudchadkar, Emory University; Ngoc Gunter, Emory University; Janice M. Mehnert, Rutgers Cancer Institute of New Jersey; Evan J. Lipson, Johns Hopkins University
• Journal Title: Journal for ImmunoTherapy of Cancer
• Volume: Volume 2
• Publisher: BioMed Central | 2014-10-14
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1186/s40425-014-0033-1
• Subjects: Health Sciences, Oncology; Health Sciences, Immunology
• Keywords: Hepatitis B; Hepatitis C; Ipilimumab; Melanoma

Abstract

Ipilimumab is a fully human, monoclonal antibody directed against Cytotoxic T Lymphocyte Antigen-4 (CTLA-4) that has demonstrated a survival benefit and durable disease control in patients with advanced melanoma. Ipilimumab is associated with potentially serious immune-related adverse events, including autoimmune hepatitis. Because clinical trials of ipilimumab excluded patients with pre-existing hepatitis B or C infection, there is a paucity of data on the safety of ipilimumab administration to that patient population. Here, we report the largest case series to date of patients with hepatitis B or C who received ipilimumab for advanced melanoma. Two of the nine patients described in this case series experienced fluctuations in their liver function tests (LFTs) and were subsequently treated with corticosteroids. Although this is a small series, the rate of hepatotoxicity appears similar to what has been seen in the general population treated with ipilimumab, and the ability to administer ipilimumab did not appear to be affected by concomitant hepatitis B or C infection. The use of ipilimumab in patients with metastatic melanoma who have pre-existing hepatitis can be considered among other therapeutic options.