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  • Poster presentation
  • Open Access

Sequential treatment with ipilimumab and BRAF inhibitors in patients with metastatic melanoma: data from the Italian ipilimumab expanded access programme (EAP)

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Journal for ImmunoTherapy of Cancer20131 (Suppl 1) :P69

  • Published:


  • Melanoma
  • Overall Survival
  • Brain Metastasis
  • Median Overall Survival
  • Metastatic Melanoma


Data to guide the order in which ipilimumab and vemurafenib are used in patients with advanced melanoma are limited. Here are reported outcomes from patients treated in the ipilimumab EAP who received both drugs.


Patients with pretreated, BRAFV600 mutation-positive advanced melanoma who had received BRAF inhibitor before or after ipilimumab were eligible for analysis.


93 patients were eligible: 48 patients received a BRAF inhibitor after ipilimumab and 45 patients ipilimumab after a BRAF inhibitor. Median overall survival (OS) was 14.5 and 9.9 months for the two groups, respectively (P=0.04). Among patients who received a BRAF inhibitor first, 18 (40%) had rapid disease progression and were unable to complete ipilimumab treatment as for protocol (rapid progressors). For this group median OS from the cessation of treatment with a BRAF inhibitor was 1.2 months. 27 patients had slower disease progression and were able to complete all four doses of ipilimumab (slow progressors); median OS was significantly longer (12.7 months; P<0.0001).Younger age and the presence of brain metastasis were significantly associated with a poorer outcome (P=0.02).


This EAP data suggests that pretreated, BRAF-mutated patients who have rapid disease progression upon failing treatment with a BRAF inhibitor die in one month, so they may benefit from receiving ipilimumab as the first part of their sequential regimen, otherwise clinical benefit may be limited due to them not being able to receive the full induction treatment.

Authors’ Affiliations

Istituto Nazionale Tumori Fondazione "G. Pascale", Naples, Italy
Institute of Oncology IOV-IRCCS, Padua, Italy
San Martino Hospital-National Institute for Cancer Research, Genoa, Italy
National Cancer Institute, Milan, Italy
Romagna National Cancer Institute, Meldola, Italy
Dermathopatic Institute of the Immaculate, Rome, Italy
Sant'Andrea Hospital, University Sapienza, Rome, Italy
Istituto Europeo di Oncologia, Milan, Italy
Regina Elena National Cancer Institute, Rome, Italy
University Hospital St John the Baptist, Turin, Italy
National Cancer Research Center "Giovanni Paolo II", Bari, Italy
"Gathered Hospitals of Santa Chiara", Pisa, Italy
Papa Giovanni XXIII Hospital, Bergamo, Italy
San Raffaele Hospital, Milan, Italy
Paolo Giaccone Polyclinc University Hospital, Palermo, Italy
Piedmont Oncology Foundation, Candiolo, Italy
Hosptal of Siena Istituto Toscano Tumori, Siena, Italy


© Ascierto et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.