The melanoma community was buzzing today with the news that the FDA approved Yervoy (ipilimumab) for people with advanced disease, making this the first new melanoma drug to come on the market in 13 years. I expect to hear about this for days to come from friends who know that I must have an opinion about it.
Indeed I do.
The main thing is, I’m in no hurry to sign up. It’s been estimated that the full four-course treatment regimen will cost $120,000. I haven't heard what insurance companies are likely to pay. And Yervoy has a therapeutic benefit in only about 20% of patients. And it has severe, sometimes life-threatening side-effects. By way of comparison, an hour or two of surgery to have metastases carved out of assorted body parts is a walk in the park.
This approval does give me something new to talk about with my oncologists, however. It was expected that Yervoy would only be approved for patients with unresectable tumors who had failed other therapy, but the FDA has said that it can be used for previously untreated patients with metastatic melanoma (that includes me). So if I should “get tired” of having mets surgically removed, as Dr. V put it when we last met, it’s conceivable I could go straight to Yervoy. That might preserve me from the dreaded interleukin-2, for which patients must be hospitalized just to be treated.
I’m hoping and praying that this will all remain a theoretical discussion for a long time. The bottom line is that for those patients who respond to Yervoy, it buys them a few months. That may not be a bad thing when the chips are really down, but it’s not a game-changer. My best move right now might be to buy some stock in Bristol-Myers Squibb. It stands to make a cool billion dollars a year from this stuff.