slow accrual & early closure

Phase IV, open-label, randomized, two-arm, multi-center study in patients with metastatic melanoma who are treatment naïve or have previously received a single non-immunologic therapy.

Treatment Arm 1: "HD IL-2 first, then ipilimumab" Patients will receive two courses (four cycles) of High Dose Interleukin-2 (HD IL-2) followed by one course (four doses) of ipilimumab.

Treatment Arm 2: Ipilimumab first then HD IL-2 Patients will receive one course (four doses) of ipilimumab followed by two courses (four cycles) of HD IL-2.

All patients will receive IL-2 at 600,000 international units per kilogram (kg) by intravenous bolus (IVB) every 8 hours for up to 14 planned doses with an additional cycle 14 days after the first.

Ipilimumab 3mg/kg IV infusion Q3 weeks up to 4 doses4 doses A 3-6 week interval been the administration of the two drugs to allow for resolution of treatment-related toxicities.

If corticosteroids were required during Ipilimumab administration, a 2-week period from discontinuation of steroid treatment to start of HD IL-2.

Inclusion Criteria:

• Male or female patients 18 years or older
• Confirmed and measurable metastatic melanoma with at least one measurable lesion for evaluation of response
• Meets the requirements for HD IL-2 therapy per Institutional guidelines
• Meets the requirements for ipilimumab therapy per Institutional guidelines
• Treatment naïve or has received only one systemic therapy apart from adjuvant therapy.
• At least 4 weeks since last adjuvant therapy or other cancer treatment
• Willing and able to give informed consent and participate in study procedures as described in the 12PLK02 and 10PLK13 protocols. Patients consented for 12PLK02 will also be asked to participate in the 10PLK13 PROCLAIM registry study.

Exclusion Criteria:

• Patients with known or suspected infection with human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) or other infectious hepatitis
• Pregnant, nursing or planning to become pregnant
• Untreated brain metastases. (Brain metastases that have been treated, which no longer require corticosteroid therapy and are without progression by MRI at least 6 weeks after definitive therapy are acceptable.)
• Received prior ipilimumab therapy (Prior Adjuvant Ipilimumab and Adjuvant Interferon are permitted with a minimum 4 week washout)
• Received prior HD IL-2 therapy.
• Received investigational drug within 30 days prior to study dosing. Patients may participate in non-interventional or observational clinical studies, including the 10PLK13 PROCLAIM registry study.
• Concomitant disease or condition that would interfere with the conduct of the study or that would, in the opinion of the Investigator, pose an unacceptable risk to the patient in this study.

Adverse events were monitored/ assessed for up to 30 weeks after 1st dose of study drug. All -cause mortality monitored/assessed up to 1 year.

AEs and SAEs listed as described below by arm and not specific for each drug. Adverse events were not assessed separately for each drug; However, side effects of each drug are established and commented in the final manuscript.

This study enrollment planned for 50 in each arm; but ended early 29 pts enrolled due to change in treatment options; the purpose of the study was to determine which sequence of approved therapy was more effective and safe; this was not a planned cross-over study complete data collection and final summary is limited due to limited data available Due to sponsor changes, and databases are no longer available.