Loading
Ipilimumab was the first checkpoint inhibitor (2011), and proved the immune system could be unleashed against cancer.
Ipilimumab is a fully human IgG1 antibody against CTLA-4 that enhances T-cell priming by stopping CTLA-4 from outcompeting CD28 for B7 ligands, and depletes intratumoural regulatory T cells through Fc effector function. It was the first checkpoint inhibitor, approved in 2011 for metastatic melanoma after monotherapy improved overall survival (2010 NEJM), and proved the immune system could be unleashed against cancer. It is now mostly given with nivolumab in melanoma, RCC, MSI-high colorectal cancer, HCC, mesothelioma and NSCLC, at 3 mg/kg in melanoma and 1 mg/kg elsewhere. In CheckMate 067 the combination produced 10-year overall survival of 43 percent versus 37 percent for nivolumab alone and 19 percent for ipilimumab alone. Immune-related adverse events are frequent, with colitis in 25 percent and hepatitis in 15 percent alongside nivolumab, and severe cases end treatment.
Backbone ribbon from PDB 5TRU. RCSB PDB 5TRU. The ribbon widens where the chain is folded into a regular pattern and narrows where it is a loose loop.
Fully human IgG1 anti-CTLA-4; enhances T-cell priming and depletes intratumoural Tregs. Connects to CTLA-4.
1.Antibody binds CTLA-4 on T cells in lymph nodes and tumour
Source: US prescribing information (DailyMed). Doses are for orientation; the current label governs.
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. HCPCS J9228.
Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments.
20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
Sources: NICE TA319 · SMC advice: ipilimumab. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Metastatic melanoma: first checkpoint inhibitor approved anywhere source
Adjuvant stage III melanoma (10 mg/kg; later superseded) source
With nivolumab in RCC source
In combination with nivolumab, is indicated for the treatment of adults and pediatric patients 12 years and older with microsatellite instability-high (MSI-H) or DNA mismatch repair deficient (dMMR), metastatic colorectal cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan
Accelerated approval on a surrogate endpoint, with a confirmatory trial required.
In combination with nivolumab, for the treatment of patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib
Accelerated approval on a surrogate endpoint, with a confirmatory trial required.
With nivolumab in first-line NSCLC (CheckMate 227) and HCC source
With nivolumab in mesothelioma (CheckMate 743) source
In combination with nivolumab, is indicated for the treatment of adults and pediatric patients 12 years and older with microsatellite instability-high (MSI-H) or DNA mismatch repair deficient (dMMR), metastatic colorectal cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan
Confirmed: the accelerated approval of 2018 converted to traditional approval 6.7 years after it was granted.
In combination with nivolumab, for the treatment of patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib
Confirmed: the accelerated approval of 2020 converted to traditional approval 5.1 years after it was granted.
With nivolumab first-line MSI-H/dMMR colorectal cancer (CheckMate 8HW) source
| Region | Year | Indication |
|---|---|---|
| US | 2011 | Metastatic melanoma |
| England (NICE) | 2025 | Untreated unresectable or metastatic MSI-high or dMMR colorectal cancer, with nivolumab · TA1065, published 28 May 2025. |
| England (NICE) | 2021 | Untreated metastatic non-small-cell lung cancer, with nivolumab and two cycles of platinum doublet chemotherapy: not recommended · TA724, published 8 September 2021. |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Colitis (with nivolumab 1+3) | 25% | 14.4% |
| Hepatitis (with nivolumab) | 15% | 13.4% |
| Hypothyroidism (with nivolumab) | 20% | 0.4% |
| Rash (with nivolumab) | 28% | 4.8% |
| Adrenal insufficiency (with nivolumab) | 8% | 2.6% |
| Hyperthyroidism (with nivolumab) | 9% | 0.9% |
Nivolumab 1 mg/kg + ipilimumab 3 mg/kg, melanoma. Rates read from the US prescribing information. Blank cells mean the figure was not sourced, not that it is zero.
Read for the class this product belongs to (immune checkpoint inhibitors) unless the answer names the product. Population figures from the cohorts named, not a prediction for one person. Blank where no source gives a recovery figure.
| Country | Reimbursement | List price | Assistance |
|---|---|---|---|
| United States | Medicare Part B (physician-administered); commercial plans per formulary | not disclosed | bmsaccesssupport.com |
| United Kingdom | NICE: recommended with nivolumab in melanoma, RCC, MSI-H CRC, mesothelioma, HCC | not disclosed | - |
List prices are manufacturer or Medicare figures where publicly disclosed; net prices after rebates are usually lower. Reimbursement changes; check the payer.
Country and place are remembered in this browser only. A postcode is sent to OpenStreetMap's Nominatim service to find coordinates when you press the button; nothing else leaves your device.
Single-agent PD-1 blockade remains the immunotherapy standard after chemotherapy in metastatic anal cancer; CTLA-4 blockade adds toxicity without benefit.
For patients with advanced melanoma, immunotherapy offers a realistic chance of long-term survival and probably cure, and the ten-year data show that patients who are alive and progression-free at three years rarely die of melanoma afterwards. Nivolumab plus ipilimumab gives the best long-term results but at a high price in serious side effects; nivolumab alone or nivolumab plus relatlimab are alternatives for patients at lower risk or with autoimmune concerns. The trial is also a caution about surrogate endpoints: the survival plateau took years to become visible.
Nivolumab-ipilimumab is a first-line standard for microsatellite-unstable metastatic colorectal cancer alongside pembrolizumab, with the trade-off of more immune toxicity for deeper and more durable control.
Patients with melanoma that has spread to palpable lymph nodes should now be offered immunotherapy before rather than only after surgery: two cycles of low-dose ipilimumab with nivolumab, then surgery, with the pathology result deciding whether any more treatment is needed. Most patients respond well and are spared a year of adjuvant therapy. Serious side effects are more common than with nivolumab alone, mostly endocrine, and the approach requires close coordination between oncologists, surgeons and pathologists.
For colon cancer that is mismatch-repair deficient (about 10-15% of colon cancers, more in older patients), a single short course of immunotherapy before surgery is now a reasonable standard and is far more effective than chemotherapy, which has little effect in this subtype. It requires testing every colon cancer for mismatch repair at diagnosis, before surgery. Whether some patients can safely skip surgery, as in dMMR rectal cancer, is the next question.
Combination checkpoint blockade became a first-line standard for mismatch repair-deficient metastatic colorectal cancer in 2025; the later all-lines comparison against nivolumab alone showed the CTLA-4 antibody adds to the PD-1 antibody, the first phase 3 to prove that in this disease.
Immunotherapy first is the standard for BRAF-mutant advanced melanoma in patients who can wait for a response; targeted therapy is reserved for rapid control or after immunotherapy.
This trial supplied the randomised proof that was missing for TIL therapy and showed academic centres can run cell-therapy phase 3 trials without industry. It supports TIL as a standard option after checkpoint inhibitor failure in melanoma and underpinned reimbursement in the Netherlands. The comparator, ipilimumab, is itself only modestly effective in this setting, and overall survival did not differ significantly.
Query for this drug: (TITLE:"Ipilimumab" OR ABSTRACT:"Ipilimumab" OR TITLE:"Yervoy" OR ABSTRACT:"Yervoy") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Ipilimumab, not a curated reading list.
Shares Nivolumab alone or with ipilimumab in mucosal melanoma: pooled analysis, A Study of Nivolumab Combined With Ipilimumab Versus Nivolumab Alone in Participants With Advanced Kidney Cancer, Study of mRNA-4359 Administered Alone and in Combination With Immune Checkpoint Blockade in Participants With Advanced Solid Tumors, CheckMate 8HW: nivolumab plus ipilimumab versus nivolumab alone in MSI-high metastatic colorectal cancer.
Shares CheckMate 9DW, Paul Baas, CheckMate 648, KEYNOTE-006.
Shares Predict immune side-effects before they happen and pre-empt them, Immune-related endocrinopathies (thyroiditis, hypophysitis), Immune-mediated colitis and diarrhoea, Immuno-oncology (IO) and checkpoint blockade.
Shares Tacquell (autologous melanoma-derived tumour-infiltrating lymphocytes), Paul Baas, Christian Blank, Myriam Chalabi.
Shares DREAMseq (ECOG-ACRIN EA6134): sequencing dabrafenib-trametinib and nivolumab-ipilimumab in BRAF-mutant metastatic melanoma, CheckMate 204, DREAMseq (ECOG-ACRIN EA6134), Paolo A. Ascierto.
Shares Study of mRNA-4359 Administered Alone and in Combination With Immune Checkpoint Blockade in Participants With Advanced Solid Tumors, Triplex Checkpoint Inhibitors Therapy for Advanced Solid Tumors, Different Doses of BI-1607 in Combination With Pembrolizumab and Ipilimumab, in Participants With Unresectable or Metastatic Melanoma, Ph I/II Trial of Systemic VSV-IFNβ-NIS in Combination With Checkpoint Inhibitor Therapy in Patients With Select Solid Tumors.
Shares Myriam Chalabi, Neoadjuvant checkpoint inhibitor → surgery (or no surgery) in dMMR colorectal cancer, CheckMate 142, Immuno-oncology (IO) and checkpoint blockade.
Shares Inge Marie Svane, Tacquell (autologous melanoma-derived tumour-infiltrating lymphocytes), John Haanen, Rohaas 2022: the first randomised trial of TIL therapy, against ipilimumab, in advanced melanoma.