Ipilimumab, a monoclonal CTLA-4 antibody, was the first drug improving overall survival in patients with metastatic melanoma. However, there are still unanswered questions concerning therapeutic regimes, e.g. if maintenance therapy is needed to achieve long-term response. We present three patients with metastatic melanoma who received ipilimumab after progression under chemotherapy. In all of these patients ipilimumab led to a long-term tumor control of at least 32 months. Interestingly, all of them developed severe autoimmune toxicity and ipilimumab treatment was discontinued after 1 respectively 2 cycles. The present cases demonstrate that a long-term response to ipilimumab can be achieved without maintenance therapy.

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