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Add’n of Sargramostim Improves Survival in Melanoma

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The addition of sargramostim to ipilimumab improves survival when compared to ipilimumab alone for patients with metastatic melanoma. These results were recently published in the Journal of the American Medical Association (JAMA).

Melanoma is a type of skin cancer that typically begins in the form of a mole. Metastatic melanoma refers to melanoma that has spread from its site of origin to distant sites in the body. Typically, patients with metastatic melanoma do not have long-term survival. However, certain therapies that stimulate the body’s immune system to help fight the cancer have demonstrated the ability to provide long-term survival in some patients with this disease.

Ipilimumab is a type of immune-stimulating agent that has demonstrated a prolongation of survival among patients with metastatic melanoma. Sargramostim is an agent that stimulates the body to produce more immune cells, so researchers have been questioning the efficacy of placing these two agents together to provide treatment for melanoma.

Researchers recently conducted a clinical trial evaluating 245 patients with metastatic melanoma that could not be removed by surgery. One group of patients was treated with ipilimumab only, while the other group was treated with ipilimumab plus sargramostim.

Median overall survival was 17.5 months for patients treated with ipilimumab plus sargraomstim, compared with only 12.7 months for those treated with ipilimumab only.
At 1 year, nearly 69% of patients treated with ipilimumab/sargramostim were alive, compared with only approximately 53% of patients treated with ipilimumab only.
There were no differences in the time to cancer progression between the two groups of patients.
The researchers concluded that the addition of sargramostim to ipilimumab improves survival, but not progression-free survival, compared with ipilimumab only in patients with metastatic melanoma. The authors stated that “these findings require confirmation in larger studies with longer follow-up.”

Reference: Hodi F, Lee S, McDermott D, et al. Ipilimumab plus sargramostim vs ipilimumab alone for treatment of metastatic melanoma. A randomized clinical trial. JAMA. 2014;312 (17):1744-1753.