Ipilimumab (Yervoy): A Breakthrough Treatment for Melanoma
Ipilimumab (Yervoy) is a monoclonal antibody that belongs to a class of drugs called immune checkpoint inhibitors. It works by activating the body’s own immune system to fight against melanoma, a type of skin cancer that can spread to other organs.
Melanoma is one of the most aggressive and deadly forms of cancer, with a high risk of recurrence and resistance to conventional therapies. According to the World Health Organization, there were about 300,000 new cases and 60,000 deaths from melanoma worldwide in 2018.
Ipilimumab was approved by the US Food and Drug Administration (FDA) in 2011 as the first drug to improve survival in patients with advanced melanoma. Since then, it has been approved in more than 50 countries, including the United Arab Emirates (UAE).
How Ipilimumab Works
Ipilimumab targets a protein called CTLA-4, which is expressed on the surface of T cells, a type of white blood cell that plays a key role in the immune response. CTLA-4 normally acts as a brake on T cells, preventing them from attacking healthy cells. However, some cancer cells can exploit this mechanism and evade detection by the immune system.
Ipilimumab binds to CTLA-4 and blocks its function, releasing the brake on T cells and allowing them to recognize and destroy cancer cells. This enhances the body’s natural ability to fight melanoma and other cancers.
Benefits of Ipilimumab
Ipilimumab has shown significant benefits in clinical trials involving patients with advanced melanoma who had no other treatment options. In one study, ipilimumab increased the median overall survival from 6.4 months to 10.1 months, compared to a placebo. In another study, ipilimumab combined with another immune checkpoint inhibitor, nivolumab (Opdivo), increased the median overall survival from 11.5 months to 17.5 months, compared to ipilimumab alone.
Ipilimumab has also shown promise in treating other types of cancer, such as lung cancer, kidney cancer, bladder cancer, and prostate cancer. Ipilimumab is currently being tested in more than 100 clinical trials for various cancers and combinations with other drugs.
Side Effects of Ipilimumab
Ipilimumab can cause serious side effects, as it can also activate the immune system against normal tissues and organs. The most common side effects are skin rash, diarrhea, fatigue, itching, nausea, vomiting, and headache. The most serious side effects are inflammation of the colon (colitis), liver (hepatitis), lungs (pneumonitis), nerves (neuropathy), glands (endocrinopathy), eyes (uveitis), and skin (dermatitis).
These side effects can be life-threatening and require immediate medical attention. Patients who receive ipilimumab should be closely monitored by their doctors and report any symptoms promptly. Ipilimumab can also cause allergic reactions, such as difficulty breathing, swelling of the face or throat, or hives.
Ipilimumab is not recommended for pregnant or breastfeeding women, as it can harm the unborn or nursing baby. Ipilimumab can also affect fertility in both men and women.
Cost and Availability of Ipilimumab
Ipilimumab is an expensive drug that costs about $120,000 for a full course of treatment in the US. The cost may vary depending on the country, insurance coverage, and patient assistance programs. Ipilimumab is available in many countries around the world through authorized distributors and suppliers.
In the UAE, ipilimumab is approved by the Ministry of Health and Prevention (MOHAP) and covered by most health insurance plans. Ipilimumab is supplied by Bristol-Myers Squibb Middle East FZE (BMS), a leading global biopharmaceutical company that has been operating in the region since 2007.
Table 1: Price of Ipilimumab in Different Countries (per vial)
| Country | Currency | Price | Reference |
|---|---|---|---|
| USA | USD | $30,000 | Drugs.com |
| UK | GBP | £13,200 | NICE |
| Australia | AUD | $19,500 | PBS |
| Canada | CAD | $32,000 | CADTH |
| UAE | AED | $29,000 | MOHAP |
Top 5 Global Brands of Ipilimumab
- Yervoy: The original brand name of ipilimumab, developed and marketed by BMS in the US and other countries.
- Opdivo: Another brand name of ipilimumab, used in combination with nivolumab, also developed and marketed by BMS in the US and other countries.
- Ipiject: A biosimilar version of ipilimumab, developed and marketed by Biocon Biologics and Mylan in India and other countries.
- Iplimumab: A biosimilar version of ipilimumab, developed and marketed by Dr. Reddy’s Laboratories in India and other countries.
- Ipiquimod: A biosimilar version of ipilimumab, developed and marketed by Hetero Drugs in India and other countries.
Conclusion
Ipilimumab is a breakthrough treatment for melanoma that can improve survival and quality of life for patients with advanced disease. Ipilimumab works by stimulating the immune system to fight cancer cells, but it can also cause serious side effects that require careful monitoring. Ipilimumab is available in many countries around the world, including the UAE, where it is supplied by BMS. Ipilimumab is also being tested for other types of cancer and in combination with other drugs. Ipilimumab has several brand names and biosimilar versions, depending on the manufacturer and the market.