Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb, describes the next steps to optimize the clinical use of ipilimumab (Yervoy) which is approved for pretreated and untreated metastatic melanoma. The drug improves survival and demonstrates durable clinical effects such as response and prolonged survival in some patients.

Hoos describes the next step is to further optimize benefits patients receive by investigating combination therapies and optimizing dosing schedules. The currently approved induction regiment is 4 doses in 3 week intervals. The drug is being examined in reinduction and as maintenance therapy. The investigation of these new schedules will help optimize ipilimumab's clinical use.

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Dr. Axel Hoos medical lead at Bristol-Myers Squibb Discusses the Next Steps for Ipilimumab

Dr. Hoos Discusses the Next Steps for Ipilimumab

Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb, discusses that the ipilimumab (Yervoy) label is very broad and includes both pretreated and untreated metastatic melanoma. No subset of patients has been identified that will not benefit from the drug. Evaluating prognostic information reveals that survival benefits has been found in all groups.

Dr. Axel Hoos medical lead at Bristol-Myers Squibb Discusses Which Patients are Eligible to Receive Ipilimumab

Dr. Hoos Discusses Patients Eligible to Receive Ipilimumab

Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb, elaborates on the trial comparing ipilimumab (Yervoy) plus dacarbazine to dacarbazine plus placebo, labeled study 024. The results demonstrated a significant survival benefit for patients with previously untreated metastatic melanoma (primary endpoint of the trial was overall survival).

The FDA approval of ipilimumab in March included an indication for pretreated and untreated metastatic melanoma patients. The findings from this trial further support this indication solidifying ipilimumab's role as a first-line therapy in metastatic melanoma.

Dr. Axel Hoos medical lead at bristol-myers squibb on the Ipilimumab Plus Dacarbazine Combination Trial

Dr. Hoos on the Ipilimumab Plus Dacarbazine Trial

Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb, describes that melanoma has often been viewed as a disease that is susceptible to immunotherapy simply because of the various antigens that present in the disease. Hoos goes on to explain that other indications will need to be examined more in depth and could result in another disease that is just as amendable to immunotherapy as melanoma.

Dr. Axel Hoos medical lead at Bristol-Myers Squibb on Why Melanoma is Amenable to Immunotherapy

Dr. Hoos on Why Melanoma is Amenable to Immunotherapy

Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb, describes that immunotherapy is still an emerging field, even though it has been around for a long time. He believes acceptance of immunotherapy is increasing in the oncology community and that immunotherapy will become one of the key treatment modalities in the coming years.

Dr. Hoos says that because there were no successes that provided patient benefit until recently, in the field of cancer immunotherapy has remained an emerging field. With the approval of cancer vaccine Provenge and the approval of belimumab, there is beginning to be a broader acceptance of immunotherapy in the oncology community at large. Dr. Hoos says this acceptance makes it more likely that there will be further investigations that are successful.

Dr. Axel Hoos from Bristol-Myers Squibb Explains the Future of Immunotherapy and Ipilimumab's role

Dr. Hoos Explains the Future of Immunotherapy

Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb discusses ipilimumab (Yervoy) and how it is a first-in-class agent that enhances activation of T cells. He elaborates that Bristol-Myers Squibb plans to build upon this success with their new drug the anti-PD-1 agent MDX-1106.

Dr. Axel Hoos medical lead from Bristol-Myers Squibb Describes Ipilimumab and Future Immunotherapies

Dr. Hoos Describes Ipilimumab and Future Immunotherapies

Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb describes the tools currently available and peer reviewed for the measurement of ipilimumab's success. These studies all need to be validated prospectively in comparison to standard processes.

Dr. Axel Hoos from Bristol Myers-Squibb on Tools Available to Measure Ipilimumab's Success

Dr. Hoos on Tools Available to Measure Ipilimumab's Success

Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb discusses the need to understand the clinical kinetics of immunotherapy and how using the body's own immune system differs from the standard chemotherapy method - specifically in regards to measuring response.

Dr. Hoos says the immunotherapy community has spent time trying to identify how they can best investigate therapies and step away from the conventional chemotherapy paradigm, which is the standard for investigating cancer agents. Some progress was made in terms of understanding the clinical kinetics of immunotherapies, such as how fast they act in the patient and how to identify end points to measure those activities. That has led to an understanding of survivor kinetics.

Dr. Axel Hoos the medical lead in Immunology/Oncology at Bristol-Myers Squibb Discusses the Clinical Kinetics of Immunotherapy

Dr. Hoos Discusses the Clinical Kinetics of Immunotherapy

Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb discusses the multiple immunotherapy agents in development, including the most advanced anti-PD-1 agent MDX-1106 which has a similar mechanism of action to ipilimumab (Yervoy).

Dr. Axel Hoos Medical Lead in Immunology/Oncology at Bristol-Myers Squibb on a Possible Successor Drug to Ipilimumab

Dr. Hoos on a Possible Successor Drug to Ipilimumab

Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb discusses key points of the ipilimumab phase III trial looking at patients with untreated metastatic melanoma; a separate trial studied pretreated patients. The trial looked at the long-term survival in patients treated with ipilimumab with or without combination with dacarbazine. The combination therapy was more successful in terms of a survival benefit. Patients saw durable responses in the form of a shrinking tumor size for a median of 19 months compared to 8 months in the control; a PFS survival was also noted.

Dr. Hoos From Bristol-Myers Squibb Discusses Key Points of the Ipilimumab Trial

Dr. Hoos Discusses Key Points of the Ipilimumab Trial

Axel Hoos, MD, PhD, the medical lead in Immunology/Oncology at Bristol-Myers Squibb describes that roughly 15% of patients have a response to ipilimumab by conventional criteria (which means to shrinking the tumor). Hoos notes that durability is the importance part of the findings with a median duration of 19 months.

Dr. Axel Hoos from Bristol Myers-Squib on the Patients That Respond to Ipilimumab

Axel Hoos, MD, PhD

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