Ipilimumab for the treatment of melanoma

Melanoma is the sixth most common cancer in the US. Metastatic melanoma has increased in incidence over the past 30 years. In the US approximately 8600 people died from melanoma in 2009. It is an aggressive tumor; the prognosis of stage IV is poor. Before 2011, only dacarbazine and IL-2 were approved for metastatic melanoma. Major advances have been made in understanding the genetic profile, molecular factors that drive malignant transformation and the role of T cells in melanoma patients. Immune regulatory pathways affecting immune responses to cancer are becoming better defined. Cytotoxic T-lymphocyteassociated antigen 4 (CTLA-4) downregulates the pathways of T-cell activation. Ipilimumab is an anti CTLA-4 monoclonal antibody approved in 2011 to treat metastatic or unresectable melanoma.