Skip to main content
. Author manuscript; available in PMC: 2014 Aug 8.
Published in final edited form as: N Engl J Med. 2013 Jun 2;369(2):134–144. doi: 10.1056/NEJMoa1305133

Figure 2. Tumor Responses with Lambrolizumab.

Figure 2

Shown are examples of tumor responses in patients treated with lambrolizumab. Panel A shows images obtained from a patient with BRAF nonmutant metastatic melanoma who had symptomatic progression after biochemotherapy and treatment with high-dose interleukin-2 and ipilimumab; the patient had rapid resolution of symptoms and showed a partial response with lambrolizumab at the initial imaging on day 90. Arrows point to sites of melanoma metastases in the lung and liver. Immunohistochemical staining of biopsied specimens obtained before and after treatment show an increased CD8 T-cell infiltrate after treatment. Panel B shows the resolution of a local relapse of desmoplastic melanoma in a patient who had not received prior treatment with ipilimumab; an additional tumor response was observed in nodal and lung metastases (not shown). CD8 immunohistochemical staining of biopsy specimens obtained before and after treatment shows increased CD8 T-cell infiltrate. Panel C shows images from a patient without prior treatment with ipilimumab who had metastatic mucosal melanoma with significant progression at the initial 12-week imaging (red boxes), at which time lambrolizumab was discontinued. Without receiving any other therapy, the patient went on to have a nearly complete response that is ongoing more than 1 year after the start of the study. Panel D is a plot of the change in tumor burden (assessed as the longest dimension of the lesion) over time in patients with melanoma who had not received prior treatment with ipilimumab and who received lambrolizumab at a dose of 10 mg per kilogram of body weight every 2 weeks. In most patients who had an objective response, the responses were durable and were evident at the initial evaluation (12 weeks). Tumor regression followed both conventional and immune-related patterns of response, such as a prolonged reduction in the tumor burden in the presence of new lesions.