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Experience levels with ipilimumab vary greatly, particularly in the community setting. As a result, moderator Mario Sznol, MD, encourages community oncologists who are unfamiliar with ipilimumab to contact him prior to administration. In addition to community oncologists and nurses, patients also need education on the side effects of ipilimumab, states Jeffrey A. Sosman, MD.
Side effect management remains an important aspect of treatment with ipilimumab, especially as its role continues to expand as a treatment for patients with melanoma. Clinical trials have demonstrated that ipilimumab is an effective adjuvant therapy, placing it earlier in the treatment paradigm.
Adjuvant therapy is now commonly being offered for patients with stage IIb/c melanoma, notes Omid Hamid, MD. For these patients, clinical trials exploring novel adjuvant therapies should be offered first before interferon. In many situations, patients with stage IIc melanoma do worse than those with stage IIIa, notes Jeffrey S. Weber, MD, PhD. This phenomenon suggests that the melanoma staging system needs to be changed, Weber adds.