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Yervoy (Ipilimumab)
Table Of Contents
Ipilimumab, marketed under the brand name Yervoy and manufactured by pharmaceutical giant Bristol-Myers Squibb, is an immunotherapy treatment for late-stage melanoma. Clinical trials are testing Yervoy in people with mesothelioma, and early results are promising.
Written by Sean Marchese, MS, RN | Medically Reviewed By Dr. Daniel Landau | Edited By Walter Pacheco | Last Update: July 2, 2024
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Written by Sean Marchese, MS, RN | Medically Reviewed By Dr. Daniel Landau | Edited By Walter Pacheco | Last Update: July 2, 2024
What Is Yervoy?
Yervoy is the brand name of ipilimumab, an immunotherapy drug approved to treat mesothelioma. The pharmaceutical company Bristol Myers Squibb manufactures it.
Since its approval by the U.S. Food and Drug Administration in 2020, doctors have begun using Yervoy to treat adult patients with unresectable malignant pleural mesothelioma. Yervoy is currently only approved as a first-line mesothelioma treatment combined with nivolumab (Opdivo).
Yervoy is a monoclonal antibody and part of the immune checkpoint inhibitor drug class. It binds to the CTLA-4 protein to prevent immune suppression. Doctors may prescribe Yervoy every six weeks with nivolumab every three weeks.
How Does Yervoy Work to Treat Mesothelioma?
Yervoy is a checkpoint inhibitor immunotherapy drug that increases the effectiveness of the body’s T cells.
T cells are white blood cells. They are part of the immune system that fights infections and cellular abnormalities such as cancer. Yervoy inhibits the CTLA-4 protein that blocks immune response. It improves the ability of T cells to recognize and attack cancer cells. This mechanism increases your immune system’s natural defenses to help kill cancer cells.
Doctors administer Yervoy through an IV line in your vein or an access port. Pleural mesothelioma patients receive Yervoy every six weeks alongside Opdivo every three weeks for up to two years.
Immune checkpoint inhibitors now provide a viable alternative to chemotherapy for eligible patients. Further improvements will likely include new drugs and drug combinations to maximize benefits.
| YERVOY (IPILIMUMAB) INFORMATION | |
|---|---|
| Name | Yervoy |
| Alternate Names | Ipilimumab |
| Manufacturer | Bristol-Myers Squibb |
| Dosage | 1 mg/kg every six weeks |
| Administration Route | Intravenous |
| Active Ingredient | Ipilimumab |
| Drug Class | Monoclonal antibody, immune checkpoint inhibitor |
| Medical Code | J9228 |
| Interacting Drug | Warfarin, pradaxa, lovenox, heparin, eliquis, vemurafenib, cholera vaccine |
| Medical Studies | Ipilimumab and Nivolumab in the Treatment of Malignant Pleural Mesothelioma (INITIATE) |
| FDA Warning | Liver damage, thyroid dysfunction, fatigue, diarrhea, pruritus, nerve problems, eye problems, rash, colitis, fetal harm |
Yervoy Side Effects
The potential benefits of Yervoy are not without the risk of side effects. Some side effects, such as fatigue, are minimal and go away when treatment ends. Other side effects are more serious, such as the risk of developing nerve problems or colitis (inflammation of the colon’s inner lining).
Patients on Yervoy and Opdivo may experience side effects of one drug or both, which may differ from the side effects of Yervoy alone.
Side effects of Yervoy may include:
- Tiredness
- Diarrhea
- Nausea
- Itching
- Rash
- Vomiting
- Headache
- Fever
- Weight loss
- Decreased appetite
- Difficulty falling or staying asleep
People on combination therapy with Yervoy and Opdivo may have different reactions. Each immunotherapy drug has a list of potential side effects. Combination treatment can cause other unique adverse effects. Chemotherapy combined with Opdivo and Yervoy causes constipation in many people.
Possible side of effects of Yervoy with Opdivo:
- Pain in muscles, bones and joints
- Cough
- Abdominal pain
- Shortness of breath
- Upper respiratory tract infection
- Low thyroid hormone levels (hypothyroidism)
- Dizziness
Bristol Myers Squibb cautions that the list of possible side effects may not be comprehensive.
Treating side effects early minimizes the risk of long-term injury. Tell your doctor immediately if you notice any changes to your body while taking Yervoy so they can offer quick and effective treatment. Patients can also report side effects directly to the FDA by calling 1-800-FDA-1088.
Yervoy in Mesothelioma Treatment Research
Clinical trial results across many U.S. cancer centers have been promising. They show that Yervoy is effective against mesothelioma when combined with Opdivo.
The CheckMate 743 clinical trial paved the way for Opdivo and Yervoy’s FDA approval to treat pleural mesothelioma. In April 2022, the study posted an update on its 605 pleural mesothelioma patients. Those treated with Opdivo and Yervoy had a median survival of 18.1 months compared to 14.1 months for chemotherapy alone.
In January 2022, the National Cancer Institute opened a clinical trial testing Yervoy with LMB-100. The latter is a protein engineered to kill cancer cells. The NCI opened the phase I trial to pleural and peritoneal mesothelioma patients.
The University of Chicago Medicine Comprehensive Cancer Center began enrolling patients in 2020 for a multimodal therapy trial. It is examining the effects of Opdivo and Yervoy when added to peritoneal mesothelioma surgery.
In June 2017, French researchers announced the results of phase II clinical trials of Yervoy and Opdivo. All participants in the study had inoperable mesothelioma that had returned following one or two lines of chemotherapy with pemetrexed and cisplatin or carboplatin.
Approximately 50% of the 54 participants treated with the immunotherapy drug combination responded well. Tumors shrunk in nearly 26% of patients, and another 24% of patients showed no new tumor growth.
Results such as these are remarkable in the treatment of recurring mesothelioma. This cancer is resistant to treatment. These results have researchers excited about what future studies may hold for mesothelioma.
Find Immunotherapy Clinical Trials
Learn how to access mesothelioma clinical trials utilizing immunotherapy.
Sign Up NowUV1 Vaccine with Opdivo and Yervoy
A 2020 phase II clinical research trial sponsored by Bristol Myers Squibb is testing the progression-free survival benefit of the UV1 cancer vaccine with nivolumab and ipilimumab in malignant pleural mesothelioma patients. Eligible patients must have disease progression after standard chemotherapy. Preliminary results are expected in 2022.
Yervoy in Combination with Novel Antibody
In 2017, researchers launched a phase II study testing the novel antibody INCAGN01867 with Opdivo, Yervoy and Opdivo plus Yervoy. The trial is targeting patients with advanced or metastatic malignancies, including mesothelioma. It was completed in November 2021, but early results are unavailable.
INITIATE Study
In 2016, researchers in the Netherlands launched a landmark trial called INITIATE. It studied ipilimumab and nivolumab as a second-line treatment for pleural mesothelioma.
The phase II study followed 33 patients with unresectable mesothelioma. They had disease progression following platinum-based chemotherapy. Researchers found that combination therapy promoted T cell proliferation. Treatment with Opdivo alone did not.
MAPS2 Trial
MAPS2 studied the effects of Opdivo and Yervoy as second-line therapy for pleural mesothelioma. MAPS2 launched in 2016 and enrolled 125 patients. At 12 weeks, 44% of patients on nivolumab achieved disease control compared to 50% in the nivolumab plus ipilimumab group.
The study successfully demonstrated anti-cancer activity without unexpected toxicity in relapsed patients with malignant pleural mesothelioma. Similar studies will likely lead to FDA approval for Opdivo and Yervoy as second-line treatments for mesothelioma.
What to Discuss with Your Doctor Before Taking Yervoy
It’s essential to discuss your medical history and any concerns with your doctor before taking Yervoy. For example, pregnancy is a severe contraindication, and Yervoy can harm your unborn baby. Patients on Yervoy should avoid breastfeeding during Yervoy treatment and for three months after the last dose.
Patients considering Yervoy should also provide a comprehensive list of their medications to their health care provider. Some drugs that bind to CTLA-4 can cause severe or fatal immune-mediated reactions. Potential drug interactions include certain vaccines (such as cholera), palifermin, Eliquis, Abraxane and Crestor.
Yervoy may cause complications in certain patients. Cytomegalovirus has been reported in patients with steroid-refractory immune-mediated colitis, a potential side effect of Yervoy. Ipilimumab should also be used cautiously in patients with a history of organ transplants, autoimmune disease or neurological disease.
Common Questions About Yervoy for Mesothelioma
- Are Opdivo and Yervoy approved for mesothelioma?
-
Yes, the U.S. Food and Drug Administration approved Opdivo and Yervoy combination immunotherapy for first-line treatment of unresectable malignant pleural mesothelioma.
- How do Opdivo and Yervoy work?
-
Opdivo is a checkpoint inhibitor that blocks PD-1, a pathway cancer cells use to hide from the immune system. Yervoy is a monoclonal antibody that targets cytotoxic T lymphocyte-associated antigen (CTLA-4). It is a protein that restricts the activity of the immune system. They prohibit cancer cell protection and elevate T-cell activity.
- What are the survival rates for Opdivo and Yervoy?
-
A 2021 clinical trial of Opdivo and Yervoy showed a median overall survival of 18.1 months. This compared with 14.1 months for patients on chemotherapy. The two-year survival rate for patients on Opdivo and Yervoy was 41%, compared to 27% for the chemotherapy group.
This Page Contains 14 Cited Articles
The sources on all content featured in The Mesothelioma Center at Asbestos.com include medical and scientific studies, peer-reviewed studies and other research documents from reputable organizations.
- ClinicalTrials.gov. (2022, April 4). Study of Nivolumab Combined With Ipilimumab Versus Pemetrexed and Cisplatin or Carboplatin as First Line Therapy in Unresectable Pleural Mesothelioma Patients (CheckMate743). Retrieved from https://www.clinicaltrials.gov/ct2/show/NCT02899299
- ClinicalTrials.gov. (2022, February 16). Phase 1/2 Study Exploring the Safety, Tolerability, and Efficacy of INCAGN01876 Combined With Immune Therapies in Advanced or Metastatic Malignancies. Retrieved from https://clinicaltrials.gov/ct2/show/study/NCT03126110
- Nakajima, E.C. et al. (2022, February 1). FDA Approval Summary: Nivolumab in Combination with Ipilimumab for the Treatment of Unresectable Malignant Pleural Mesothelioma. Retrieved from https://clincancerres.aacrjournals.org/content/early/2021/09/22/1078-0432.CCR-21-1466.abstract
- ClinicalTrials.gov. (2021, October 26). Nivolumab and Ipilimumab +/- UV1 Vaccination as Second Line Treatment in Patients With Malignant Mesothelioma (NIPU). Retrieved from https://clinicaltrials.gov/ct2/show/NCT04300244
- ClinicalTrials.gov. (2021, February 10). Nivolumab Monotherapy or Nivolumab Plus Ipilimumab, for Unresectable Malignant Pleural Mesothelioma (MPM) Patients (MAPS2). Retrieved from https://www.clinicaltrials.gov/ct2/show/NCT02716272
- ClinicalTrials.gov. (2021, January 20). Ipilimumab and Nivolumab in the Treatment of Malignant Pleural Mesothelioma (INITIATE). Retrieved from https://www.clinicaltrials.gov/ct2/show/NCT03048474
- Mankor, J.M. et al. (2020, November 7). Efficacy of nivolumab and ipilimumab in patients with malignant pleural mesothelioma is related to a subtype of effector memory cytotoxic T cells: Translational evidence from two clinical trials. Retrieved from https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(20)30416-3/fulltext
- ClinicalTrials.gov. (2020, September 1). A Study Exploring the Safety and Efficacy of INCAGN01949 in Combination With Immune Therapies in Advanced or Metastatic Malignancies. Retrieved from https://www.clinicaltrials.gov/ct2/show/NCT03241173/
- Bristol Myers Squibb. (2020). What is Yervoy (ipilimumab)? Retrieved from https://www.bms.com/assets/bms/ca/documents/productmonograph/YERVOY_EN_PM.pdf
- Scherpereel, A. et al. (2019, January 16). Nivolumab or nivolumab plus ipilimumab in patients with relapsed malignant pleural mesothelioma (IFCT-1501 MAPS2): a multicentre, open-label, randomised, non-comparative, phase 2 trial. Retrieved from https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30765-4/fulltext
- Dana-Farber Cancer Institute. (2018, December 13). What Is CTLA-4 and How Does it Work in Treating Metastatic Melanoma? Retrieved from http://blog.dana-farber.org/insight/2015/12/what-is-ctla-4-and-how-does-it-work-in-treating-metastatic-melanoma/
- Scherpereel, A. et al. (2017, June 5). Second- or third-line nivolumab (Nivo) versus nivo plus ipilimumab (Ipi) in malignant pleural mesothelioma (MPM) patients: Results of the IFCT-1501 MAPS2 randomized phase II trial. Retrieved from https://meetinglibrary.asco.org/record/145342/abstract
- ESMO. (2015, November 3). FDA approves ipilimumab to reduce the risk of melanoma returning after surgery. Retrieved from https://www.esmo.org/Oncology-News/FDA-Approves-Ipilimumab-to-Reduce-the-Risk-of-Melanoma-Recurrence-After-Surgery
- Hodi, F. et al. (2010, August 19). Improved Survival with Ipilimumab in Patients with Metastatic Melanoma. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa1003466
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