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Yervoy (ipilimumab)

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 lymph nodes are removed with surgery.1

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 CLTA-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 antigen 4.” Ipilimumab may described as:

  • immune checkpoint inhibitor
  • anti-CLTA-4 antibody
  • CTLA-4 blocking antibody
Ipilimumab
Ipilimumab
Ipilimumab

How is Ipilimumab given?

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.

Patients with metastatic or unresectable melanoma usually receive Ipilimumab every 3 weeks.1 A total of 4 doses are given. 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. The first 4 doses are given every 3 weeks. After that, you will receive a dose of Ipilimumab every 12 weeks for up to 3 years.

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

Rare but serious possible side effects of Ipilimumab include:

  • Intestinal inflammation (colitis)
  • Liver inflammation (hepatitis)
  • Skin problems and severe skin reaction
  • Nerve problems that can lead to paralysis
  • Problems with hormone glands (pituitary, adrenal, and thyroid)
  • Eye problems

This is not a complete list of adverse effects.

Who should not take Ipilimumab?

Ipilimumab can harm an unborn baby.1 Women who could become pregnant should use effective birth control during treatment. Continue using birth control for at least 3 months after the last dose of Ipilimumab. Do not breastfeed during treatment with Ipilimumab or for 3 months after.

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

Women who can become pregnant should use birth control during and for at least 3 months after treatment.1 Women should not breastfeed during treatment or for 3 months after receiving Ipilimumab.

Written by: Sarah O'Brien | Last reviewed: June 2019.
  1. Yervoy® [prescribing information]. Princeton, NJ: Bristol-Myers Squibb; March 2017.
  2. PubMed Health. T-Lymphocytes (T-Cells). Accessed April 7, 2017 at: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022044/
  3. Lipson EJ, Drake CG. Ipilimumab: an anti-CTLA-4 antibody for metastatic melanoma. Clin Cancer Res. 2011;17:6958-6962.
  4. NCCN Clinical Practice Guidelines in Oncology. Melanoma. Version 1.2017. Published November 10, 2016. https://www.nccn.org/professionals/physician_gls/pdf/melanoma.pdf
  5. Hodi FS, O'Day SJ, McDermott DF, et al. Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med. 2010;363:711-723.
  6. Maio M, Grob JJ, Aamdal S, et al. Five-year survival rates for treatment-naive patients with advanced melanoma who received ipilimumab plus dacarbazine in a phase III trial. J Clin Oncol. 2015;33:1191-1196.
  7. Eggermont AM, Chiarion-Sileni V, Grob JJ, et al. Adjuvant ipilimumab versus placebo after complete resection of high-risk stage III melanoma (EORTC 18071): a randomised, double-blind, phase 3 trial. Lancet Oncol. 2015;16:522-530.
  8. Larkin J, Chiarion-Sileni V, Gonzalez R, et al. Combined nivolumab and ipilimumab or monotherapy in untreated melanoma. N Engl J Med. 2015;373:23-34.
  9. Opdivo® [prescribing information]. Princeton, NJ: Bristol-Myers Squibb Company; February 2017.