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  • 1.
    Uygul Kourie, Isabella
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Effektivitet vid behandling med CTLA-4 inhibitorn ipilimumab hos patienter med avancerat malignt melanom. Är monoterapi eller kombinationsterapi med en PD1-inhibitor att föredra?: En litteraturstudie där ipilimumab jämförs i frånvaro respektive närvaro av en PD1-inhibitor 2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Malignant melanoma is a cancerous disease that increases worldwide. The disease is very serious, and the treatment can be complicated. There are currently new treatment methods that increase survival in patients with advanced malignant melanoma. The monoclonal antibody ipilimumab is one example. Ipilimumab is a CTLA-4 inhibitor that inhibits the CTLA-4 protein which leads to activity of T-cells. CTLA-4 blocks T-cells from be active and owing to the inhibition of the CTLA-4 protein, the T-cell activation is not blocked. The T-cells can thus be activated and combat cancer cells.  Another example of new therapies are PD1-inhibitors that also activate the immune system. Since both CTLA-4 and PD-1 inhibitors activate the immune system in different ways, there are prerequisites for a combination therapy of these two. The purpose of this thesis was to investigate whether treatment of ipilimumab alone is as effective in survival and tumor growth as combination therapy with ipilimumab and a PD-1 inhibitor in patients with malign melanoma. This is a literature study and the method used was search of articles in the database PubMed. Five relevant articles were selected using the keywords "ipilimumab", "ani-pd1" and “advanced melanoma”. It was found that patients treated with ipilimumab and a PD1-inhibitor had a longer overall survival, compared to patients treated with ipilimumab alone. However, more side effects occurred in patients treated with combination therapy. Patients with combination therapy also had a higher tumor reduction.  Considering that this field of science is comparative new, not so many studies have yet been done. More studies with longer follow-up times should be performed. In conclusion, patients with malign melanoma survive longer and efficiency increases in therapy with both ipilimumab and nivolumab than therapy with only ipilimumab.

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