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Briefing Note: ipilimumab (Yervoy)

SMC did not accept ipilimumab for the treatment of advanced (unresectable or metastatic) melanoma in adults who have received prior therapy.

  • Advanced melanoma is a type of skin cancer. When possible, melanoma is treated by removing the affected area surgically. A melanoma which cannot be removed in this way is said to be unresectable. A melanoma is metastatic if the cancer has spread to other parts of the body.
  • Ipilimumab is a type of anticancer medicine called a ‘T-cell potentiator’. Its active ingredient is a protein which helps the body’s immune system to attack and destroy cancer cells. It is used in people whose cancer has not responded or has stopped responding to earlier treatment and is given intravenously over a 90-minute period every 3 weeks for a total of four doses.
  • A study has shown that patients given ipilimumab survived for longer than patients given the investigational cancer vaccine gp100.   This vaccine has not demonstrated any benefit in the treatment of melanoma but was used as an active control as there is no accepted standard of care for advanced melanoma.  The median gain in overall survival in patients treated with ipilimumab was 3.6 months.
  • The most common side effects of ipilimumab were related to the immune system.  These were almost twice as common in patients given ipilimumab compared with those given gp100.  Diarrhoea was the most common immune-related side effect and this was severe in some cases.
  • SMC did not accept ipilimumab because weaknesses in the economic case submitted by the company and the justification of costs in relation to benefits meant the medicine was not considered to offer value for money.