[Anti-CTLA-4 monoclonal antibody: a major step in the treatment of metastatic melanoma]

Abstract

The anti-CTLA-4 Mab ipilimumab is an efficient treatment of metastatic melanoma as a single agent and combined with dacarbazine chemotherapy. The benefit is observed in 10 to 20 % of the patients but it is the only drug to demonstrate an increase in overall survival of patients with metastatic melanoma. The pattern of response is new with delayed and prolonged responses over time. New evaluation criteria have been proposed to evaluate the efficacy of this new therapy. The safety profile is new also with frequent and potentially severe side effects related to the activation of the immune system. The challenges are now to identify biomarkers able to predict ipilimumab benefit and to know how to use ipilimumab in combination with new targeted therapies of melanoma in order to optimize the treatment efficacy.