Experience in daily practice with ipilimumab for the treatment of patients with metastatic melanoma: an early increase in lymphocyte and eosinophil counts is associated with improved survival
Open accessAbstract
Background Ipilimumab is a recently approved immunotherapy that has demonstrated an improvement in the overall survival (OS) of patients with metastatic melanoma. We report a single-institution experience in patients treated in a compassionate-use program.Patients and methods In this prospective study, patients were treated between June 2010 and September 2011. Inclusion criteria were a diagnosis of unresectable stage III or IV melanoma, at least one previous line of chemotherapy, and survival 12 weeks after the first perfusion. Four courses of ipilimumab were administered at a dose of 3 mg/kg every 3 weeks.Results Seventy-three patients were included. Median OS was 9.1 months (95% CI 6.4-11.3) from the start of ipilimumab. Immune-related adverse events were observed in 45 patients (62%), including 19 grade 3-4 events (26%). No drug-related death occurred. A lymphocyte count >1000/mm(3) at the start of the second course and an increase in the eosinophil count >100/mm(3) between the first and second infusions were correlated with an improved OS.Conclusion Ipilimumab toxic effect is manageable in real life. Biological data such as lymphocyte and eosinophil counts at the time of the second ipilimumab infusion appear to be early markers associated with better OS.
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An elevated eosinophil count prior to treatment was associated with longer overall survival in several studies.
“Furthermore, an elevated eosinophil count prior to treatment was associated with longer overall survival in several studies.8–12”
From Moderate-to-severe eosinophilia induced by treatment with immune checkpoint inhibitors: 37 cases from a national reference center for hypereosinophilic syndromes and the French pharmacovigilance database (2020) · cites this paper as [8]
The results report that an increase in eosinophil count between the first two ipilimumab courses was associated with longer overall survival. The end point section says pretreatment counts were recorded, but the cited association concerns a change during treatment, not an elevated count prior to treatment. No page number is available in our copy. (LLM, conf=0.88)
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Self-citation
- Authors
- Delyon, J., Mateus, C., Lefeuvre, D., Lanoy, E., Zitvogel, L., Chaput, N., Roy, S., Eggermont, A. M. M., Routier, E., & Robert, C.
- Affiliations
- Institut Gustave Roussy (FR)
- Université Paris-Sud (FR)
- Inserm (FR)
- Corresponding author
- Delyon, J.
- Venue
- Annals of Oncology
- Publisher
- Elsevier BV
- Published
- 2013-06
- Volume
- 24
- Issue
- 6
- Pages
- 1697-1703
- ISSN
- 0923-7534 (ISSN-L)
- OpenAlex
- W2107863654
- Semantic Scholar
- 227acc6dc2205788c75d438e03d62ffe4cfd3073
- Cited by
- 318
- References
- 23
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 10 · 2023: 11 · 2022: 21 · 2021: 28 · 2020: 36 · 2019: 31 · 2018: 31 · 2017: 43 · 2016: 36 · 2015: 32 · 2014: 13 · 2013: 9
- FWCI
- 16.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Annals of Oncology (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Keywords
- ipilimumab, metastatic melanoma, immune checkpoint inhibitors, overall survival, lymphocyte count, eosinophil count, immune-related adverse events, prognostic factors, compassionate use program
- MeSH terms
- Ipilimumab, Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Eosinophils, Female, Humans, Lymphocytes, Male, Melanoma, Middle Aged, Prospective Studies, Skin Neoplasms, Time Factors, Survival Rate, Treatment Outcome, Lymphocyte Count, Young Adult
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