Yervoy® (ipilimumab) is a type of immunotherapy. It is used to treat melanoma that:1
- Cannot be removed with surgery (unresectable) or
- Has spread to distant parts of the body (metastasized)
Ipilimumab is also used as an adjuvant therapy. Adjuvant therapy is an additional cancer treatment that is given after the primary (main) treatment. Adjuvant therapy can help lower the risk that the cancer comes back, and ipilimumab may be used as adjuvant therapy after the skin tumor and involved lymph nodes are removed with surgery.1
Depending on the specific type of melanoma, ipilimumab can be used alone or with a medication called Opdivo® (nivolumab). Ipilimumab does not come in generic form.
How does Ipilimumab work?
Ipilimumab "removes the brakes" on your immune system’s T-cells. T-cells (T-lymphocytes) are a type of white blood cell.2 T-cells fight cancer and infection. They travel through the body, and when they identify foreign (unhealthy) cells, they become active fighter cells (Figure A below).
A receptor called CTLA-4 acts like a brake on the T-cells. If CTLA-4 binds (connects) with certain proteins on melanoma cells, the T-cell does not become active. Instead, the T-cell leaves the melanoma cell alone (Figure B below).3
Ipilimumab binds to the CTLA-4 receptor and blocks it (Figure C below).1,3 By removing the brakes, the T-cell can become active and attack the cancer cell.
CTLA-4 stands for “cytotoxic T-lymphocyte-associated protein 4.” Ipilimumab may be described as:
- immune checkpoint inhibitor
- anti-CTLA-4 antibody
- CTLA-4 blocking antibody
Receiving Ipilimumab
Before taking Ipilimumab, read the Medication Guide that comes in the package. Follow your doctor’s instructions regarding ipilimumab treatment. Talk to your doctor about how often and how many treatments you will need.
Ipilimumab is taken through an intravenous (IV) line. Your doctor will arrange for your Ipilimumab treatment. If you are receiving ipilimumab with Opdivo, you will receive both medications on the same day.9
Ipilimumab is used differently as adjuvant treatment.1 A higher dose is used.9
What are the side effects of Ipilimumab?
The most common side effects of Ipilimumab include:1
- Feeling tired
- Diarrhea
- Rash or itchy skin
- Nausea and vomiting
- Headache
- Weight loss
- Fever
- Decreased appetite
- Sleep difficulty
Less common but serious possible side effects of Ipilimumab include:
- Intestinal inflammation (colitis)
- Liver inflammation (hepatitis)
- Skin problems and severe skin reaction
- Lung inflammation (pneumonitis)
- Problems with hormone glands (pituitary, adrenal, and thyroid)
- Eye problems
This is not an exhaustive list of all potential side effects of ipilimumab. Talk to your healthcare provider or pharmacist for further information.
Who should not take Ipilimumab?
If you are pregnant, plan to become pregnant, or are breastfeeding or plan to breastfeed, talk with your doctor. Ipilimumab can cause harm to a developing fetus and should not be given to women who are pregnant. While receiving Ipilimumab, females who can become pregnant should use contraceptives during treatment and for a period of time after completing treatment (patients should discuss appropriate birth control methods, and how long they need to use them, with their doctor). Females should not breastfeed during Ipilimumab treatment and for a period of time following the final dose (patients should discuss breastfeeding considerations with their doctor).
Tell your doctor about any medical conditions you have, especially:1
- Immune system problems (such as Crohn’s disease, ulcerative colitis, lupus, or sarcoidosis).
- Previous organ transplant.
- Liver problems.
What precautions are needed when taking Ipilimumab?
You will need regular blood tests to check for side effects of Ipilimumab. Your doctor may prescribe corticosteroids or hormone replacement medicines to treat certain side effects.1
Before starting treatment with ipilimumab, patients should tell their doctor about all medications (prescription and over-the-counter), herbal supplements, and vitamins they are taking. Patients should talk to their doctor if they have any questions, or if they have questions regarding their ipilimumab regimen.