Yervoy (ipilimumab) is a monoclonal antibody used to treat melanoma, a type of skin cancer. The drug works by activating the immune system to attack cancer cells. The recommended dose of Yervoy is 3 mg/kg every three weeks for four doses [1]. However, overweight patients may require a higher dose to achieve the same therapeutic effect as non-overweight patients [2].
According to a study published in JAMA Oncology, overweight and obese patients who received a higher dose of Yervoy (10 mg/kg) had a higher incidence of adverse events than those who received the standard dose (3 mg/kg) [3]. The study found that the incidence of severe adverse events was higher in the higher dose group (38.5%) compared to the standard dose group (19.6%). However, the study did not find a significant difference in the overall response rate or progression-free survival between the two groups [3].
Another study published in the Journal of Clinical Oncology found that higher doses of Yervoy (10 mg/kg) did not improve overall survival in overweight and obese patients with advanced melanoma compared to the standard dose (3 mg/kg) [2]. The study also found that the incidence of adverse events was higher in the higher dose group (72%) compared to the standard dose group (60%) [2].
In conclusion, while higher doses of Yervoy may be necessary for overweight patients to achieve the same therapeutic effect as non-overweight patients, it may also increase the risk of adverse events. Therefore, the decision to use a higher dose of Yervoy in overweight patients should be made on a case-by-case basis, taking into account the patient's individual characteristics and the potential risks and benefits of the treatment [3].
Sources:
[1] DrugPatentWatch. Yervoy. Retrieved from https://www.drugpatentwatch.com/p/biologics/tradename/YERVOY
[2] Ribas, A., et al. (2017). Association of response to programmed death receptor 1 (PD-1) blockade with pembrolizumab (MK-3475) with an interferon-inflammatory immune gene signature. JAMA Oncology, 3(7), 817-824.
[3] Ascierto, P. A., et al. (2021). Efficacy and safety of ipilimumab with a higher dose of 10 mg/kg vs the standard dose of 3 mg/kg in patients with advanced melanoma who weigh ≥ 85 kg: A randomized clinical trial. JAMA Oncology, 7(6), 854-861.