Clinical Challenges

Nursing Management of Patients With Metastatic Melanoma Receiving Ipilimumab

Jane Bryce

Claudia Passoni

melanoma, skin cancer, metastasis, nursing management
ONF 2013, 40(3), 215-218. DOI: 10.1188/13.ONF.215-218

A 46-year-old Caucasian male named N.M. was diagnosed in March 2002 with melanoma of the trunk. The melanoma was resected and a left axillary sentinel lymph node biopsy was negative for malignant cells. Three years later, melanoma recurred to the left axillary lymph nodes, which were subsequently dissected. No adjuvant therapy was administered. In November 2007, a computed tomography (CT) scan showed multiple lesions (2-6 cm) in the abdomen wall, peritoneum, and small bowel, and a mass of 10 cm in the left axillary region. N.M. was enrolled into a phase III trial and received 850 mg/m2 dacarbazine plus 10 mg/kg ipilimumab at weeks 1, 4, 7, and 10, followed by dacarbazine alone every three weeks through week 22.

Jump to a section

    References

    Boasberg, P., Hamid, O., & O'Day, S. (2010). Ipilimumab: Unleashing the power of the immune system through CTLA-4 blockade. Seminars in Oncology, 37, 440-449. doi:10.1053/j.seminoncol.2010.09.004
    Boyle, P., & Ferlay, J. (2005). Cancer incidence and mortality in Europe, 2004. Annals of Oncology, 16, 481-488. doi:10.1093/annonc/mdi098
    Bristol-Myers Squibb. (2011). Yervoy® (ipilimumab) immune-mediated adverse management guide. Retrieved from http://www.yervoy.com/hcp/pdf/rems-management-guide.pdf
    Dummer, R., Hauschild, A., Guggenheim, M., Keilholz, U., & Pentheroudakis, G. (2012). Cutaneous melanoma: ESMO clinical practice guidelines for diagnosis, treatment, and follow-up. Annals of Oncology, 23(Suppl. 7), vii86-vii91. doi:10.1093/annonc/mds229
    Ferlay, J., Parkin, D. M., & Steliarova-Foucher, E. (2010). Estimates of cancer incidence and mortality in Europe in 2008. European Journal of Cancer, 46, 765-781. doi:10.1016/j.ejca.2009.12.014
    Fong, L., & Small, E. J. (2008). Anticytotoxic T-lymphocyte antigen-4 antibody: The first in an emerging class of immunomodulatory antibodies for cancer treatment. Journal of Clinical Oncology, 26, 5275-5283. doi:10.1200/JCO.2008.17.8954
    Harmankaya, K., Erasim, C., Koelblinger, C., Ibrahim, R., Hoos, A., Pehamberger, H., & Binder, M. (2011). Continuous systemic corticosteroids do not affect the ongoing regression of metastatic melanoma for more than two years following ipilimumab therapy. Medical Oncology, 28, 1140-1144. doi:10.1007/s12032-010-9606-0
    Hoos, A., Ibrahim, R., Korman, A., Abdallah, K., Berman, D., Shahabi, V., … Humphrey, R. (2010). Development of ipilimumab: Contribution to a new paradigm for cancer immunotherapy. Seminars in Oncology, 37, 533-546. doi:10.1053/j.seminoncol.2010.09.015
    Ibrahim, R. A., Berman, D. M., DePril, V., Humphrey, R. W., Chen, T., Messina, M., … Hoos, A. (2011). Ipilimumab safety profile: Summary of findings from completed trials in advanced melanoma [Abstract 8583]. Journal of Clinical Oncology, 29(Suppl.), 546s.
    Jemal, A., Siegel, R., Ward, E., Hao, Y., Xu, J., Murray, T., & Thun, M. J. (2008). Cancer statistics, 2008. CA: A Cancer Journal for Clinicians, 58, 71-96. doi:10.3322/CA.2007.0010
    Melero, I., Hervas-Stubbs, S., Glennie, M., Pardoll, D. M., & Chen, L. (2007). Immunostimulatory monoclonal antibodies for cancer therapy. Nature Reviews. Cancer, 7, 95-106. doi:10.1038/nrc2051
    National Comprehensive Cancer Network. (2013). NCCN Clinical Practice Guidelines in Oncology—Melanoma [v.2.13]. Retrieved from http://www.nccn.org/professionals/physician_gls/pdf/melanoma.pdf
    O'Day, S. J., Hamid, O., & Urba, W. J. (2007). Targeting cytotoxic T-lymphocyte antigen-4 (CTLA-4): A novel strategy for the treatment of melanoma and other malignancies. Cancer, 110, 2614-2627. doi:10.1002/cncr.23086
    Pennock, G. K., Waterfield, W., & Wolchok, J. D. (2012). Patient responses to ipilimumab, a novel immunopotentiator for metastatic melanoma: How different are these from conventional treatment responses? American Journal of Clinical Oncology, 35, 606-611. doi:10.1097/COC.0b013e318209cda9
    Robert, C., & Ghiringhelli, F. (2009). What is the role of cytotoxic T lymphocyte-associated antigen 4 blockade in patients with metastatic melanoma? Oncologist, 14, 848-861.
    Robert, C., Thomas, L., Bondarenko, I., O'Day, S., Weber, J., Garbe, C., … Wolchok, J. D. (2011). Ipilimumab plus dacarbazine for previously untreated metastatic melanoma. New England Journal of Medicine, 364, 2517-2526. doi:10.1056/NEJMoa1104621
    Rubin, K. M. (2012). Managing immune-related adverse events to ipilimumab: A nurse's guide [Online exclusive]. Clinical Journal of Oncology Nursing, 16, E69-E75. doi:10.1188/12.CJON.E69-E75
    Siegel, R., Naishadham, D., & Jemal, A. (2012). Cancer statistics, 2012. CA: A Cancer Journal for Clinicians, 62, 10-29. doi:10.3322/caac.20138
    Wolchok, J. D., Hoos, A., O'Day, S., Weber, J. S., Hamid, O., Lebbe, C., … Hodi, F. S. (2009). Guidelines for the evaluation of immune therapy activity in solid tumors: Immune-related response criteria. Clinical Cancer Research, 15, 7412-7420. doi:10.1158/1078-0432.CCR-09-1624