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Improved infield response rates and overall survival in patients with metastatic melanoma receiving higher biological equivalent doses of radiation with ipilimumab

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

There is a growing body of evidence that combining radiotherapy with ipilimumab might improve the survival and response rates in patients with metastatic melanoma. However, the patient and treatment variables that predict for improved outcomes have not been well defined.

Methods

We conducted a retrospective analysis of 69 patients treated with ipilimumab and radiotherapy for metastatic melanoma at a single institution from May 2011 to June 2015. Demographic, clinical, and treatment factors were recorded, and end points of interest included infield and global complete response (CR) after the completion of radiation and ipilimumab based on the RECIST criteria (v1.1), and overall survival (OS). A bivariate and multivariate analysis was then performed to assess the relationship between outcomes and patient variables.

Results

In the multivariate analysis, infield CR was significantly associated with completing a full course of ipilimumab, a higher BED, and a smaller size of metastatic area treated. Global CR was significantly associated with increased age and giving radiotherapy to all areas of disease. OS was significantly associated with completing a full course of ipilimumab and a higher BED. Interestingly, after a multivariate analysis, higher BED was associated with an improved infield CR (p = 0.0281) and was not associated with an improved global CR (p = 0.5284) but was marginally associated with improved OS (p = 0.0545).

Conclusion

Our findings suggest that the rate of a global CR is independent of the dose of radiation given, but the rate of infield CR and OS might improve with higher doses.

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Author information

Authors and Affiliations

  1. The Divisions of Radiation Oncology, 500 University Drive, CH63, Hershey, PA, 17033, USA

    Heath B. Mackley & Henry Wagner

  2. Penn State College of Medicine, Hershey, PA, USA

    Jason Liu

  3. Departments of Biostatistics, Hershey, PA, USA

    Junjia Zhu

  4. Hematology Oncology, Hershey, PA, USA

    Giampaolo Talamo, Carol A. Mallon, Kristian M. Koller & Joseph J. Drabick

  5. Departments of Microbiology and Immunology, Hershey, PA, USA

    Todd D. Schell, Rogerio I. Neves & Kathleen M. Kokolus

  6. Departments of Surgery, Hershey, PA, USA

    Colette Pameijer

  7. Departments of Dermatology, Hershey, PA, USA

    Bryan Anderson

  8. Departments of Pharmacology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA

    Jeffrey Sivik

Authors
  1. Heath B. Mackley
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  2. Jason Liu
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Corresponding author

Correspondence to Heath B. Mackley.

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Funding sources

No funding support is associated with this study.

Conflict of Interest

Heath Mackley declares that he has no conflict of interest. Jason Liu declares that he has no conflict of interest. Junjia Zhu declares that he has no conflict of interest. Henry Wagner declares that he has no conflict of interest. Giampaolo Talamo declares that he has no conflict of interest. Todd Schell declares that he has no conflict of interest. Colette Pameijir declares that she has no conflict of interest. Rogerio Neves declares that he has no conflict of interest. Bryan Anderson declares that he has no conflict of interest. Kathleen Kokolus declares that she has no conflict of interest. Jeffrey Sivik declares that he has no conflict of interest. Carol Mallon declares that she has no conflict of interest. Kristian Koller declares that he has no conflict of interest. Joseph Drabick declares that he has no conflict of interest.

Ethical approval

IRB approval has been obtained. This article does not contain any studies with human participants or animals performed by any of the authors.

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Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Mackley, H.B., Liu, J., Zhu, J. et al. Improved infield response rates and overall survival in patients with metastatic melanoma receiving higher biological equivalent doses of radiation with ipilimumab. J Radiat Oncol 6, 215–223 (2017). https://doi.org/10.1007/s13566-017-0305-8

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  • DOI: https://doi.org/10.1007/s13566-017-0305-8

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