Ipilimumab (Yervoy) Prolongs Survival in Advanced Melanoma

INTRODUCTION Melanoma, a cancer originating in melanocytes, is the most deadly form of skin cancer and the sixth leading type of cancer in the U.S.1 According to the World Health Organization, approximately 53,000 people die of melanoma each year worldwide.2 In 2011, an estimated 70,230 adults were diagnosed with melanoma in the U.S., and 8,790 died of the disease.3,4 This may be an underestimation of new cases, however, as superfi cial and in situ melanomas treated in the outpatient setting usually are not reported.5 During the past 30 years, the annual incidence of melanoma in the U.S. has grown by more than 60%.1,5 The overall increase is attributed primarily to Caucasians (Figure 1).1 The median age at diagnosis is 59 years.4 In men, melanoma is increasing more than any other malignancy; in women, it is increasing more than any other malignancy except lung cancer.5 Men 65 years of age or older are more than twice as likely to develop melanoma as women in the same age group.1 Although melanoma is the rarest type of skin cancer, the estimated lifetime risk of developing the disease is 1 in 55 people.6 Each year, approximately $1.9 billion is spent on therapy for melanoma in the U.S.7 Risk factors include a family history, a history of melanoma, multiple clinically atypical moles or dysplastic nevi,8,9 and (rarely) inherited genetic mutations.5 Sun exposure and indoor tanning may also contribute to the development of melanoma from exposure to ultraviolet radiation.10,11 Clinical stages from 0 to IV are based on tumor thickness, tumor burden in lymph nodes, and metastatic involvement. The stages are as follows:12