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Ipilimumab in the treatment of metastatic melanoma: management of adverse events

Authors Della Vittoria Scarpati G, Fusciello C, Perri F, Sabbatino F, Ferrone S, Carlomagno C, Pepe S

Received 10 November 2013

Accepted for publication 25 December 2013

Published 19 February 2014 Volume 2014:7 Pages 203—209


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Giuseppina Della Vittoria Scarpati,1,2 Celeste Fusciello,3 Francesco Perri,4 Francesco Sabbatino,5 Soldano Ferrone,5 Chiara Carlomagno,3 Stefano Pepe1,2

1Department of Medicine, University of Salerno, 2Division of Oncology, “San Giovanni di Dio e Ruggi d’Aragona” Hospital, Salerno, 3Department of Oncology, University “Federico II”, Naples, 4Head and Neck Medical Oncology Unit, National Tumor Institute, Naples, Italy; 5Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

Abstract: Recently, “ipilimumab,” an anti-cytotoxic T-lymphocyte antigen-4 (CTLA-4) monoclonal antibody, has been demonstrated to improve overall survival in metastatic melanoma. “CTLA-4” is an immune-checkpoint molecule that downregulates pathways of T-cell activation. Ipilimumab, by targeting CTLA-4, is able to remove the CTLA-4 inhibitory signal, allowing the immune system to react to cancer cells. Due to its immune-based mechanism of action, ipilimumab causes the inhibition of CTLA-4-mediated immunomodulatory effects, the enhancement of antitumor specific immune response mediated by the weakening of self-tolerance mechanisms while exacerbating the development of autoimmune diseases and immune-related adverse events, including dermatitis, hepatitis, enterocolitis, hypophysitis, and uveitis.

Keywords: melanoma, T-cells, CTLA-4, autoimmunity, adverse events

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