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Prognostic factors and outcomes in metastatic uveal melanoma treated with programmed cell death-1 or combined PD-1/cytotoxic T-lymphocyte antigen-4 inhibition
- Source :
- European Journal of Cancer. 82:56-65
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background: Uveal melanoma (UM) is an ocular malignancy with high potential for metastatic spread. In contrast to cutaneous melanoma, immunotherapy has not yet shown convincing efficacy in patients with UM. Combined immune checkpoint blockade with checkpoint programmed cell death-1 (PD-1) and checkpoint cytotoxic T-lymphocyte antigen-4 (CTLA-4) inhibition has not been systematically assessed for UM to date. Patients and methods: Patients with metastatic UM treated with either PD-1 inhibitor monotherapy or combined PD-1 inhibitor and ipilimumab (an anti-CTLA-4 monoclonal antibody) were included from 20 German skin cancer centres. Records from 96 cases were analysed for treatment outcomes. Clinical and blood parameters associated with overall survival (OS) or treatment response were identified with multivariate Cox regression and binary logistic regression. Results: Eighty-six patients were treated with PD-1 inhibitors only (n = 54 for pembrolizumab, n = 32 for nivolumab) with a centrally confirmed response rate of 4.7%. Median OS was 14 months for pembrolizumab-treated and 10 months for nivolumab-treated patients (p = 0.765). Fifteen patients were treated with combined immune checkpoint blockade with partial response observed in two cases. Median OS was not reached in this group. Multivariate Cox regression identified Eastern Cooperative Oncology Group (ECOG) performance status (p = 0.002), elevated serum levels of lactate dehydrogenase (LDH) (p = 0.002) and C-reactive protein (CRP) (p = 0.001), and a relative eosinophil count (REC)
- Subjects :
- Adult
Male
Uveal Neoplasms
0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Programmed Cell Death 1 Receptor
Antineoplastic Agents
Ipilimumab
Pembrolizumab
Antibodies, Monoclonal, Humanized
03 medical and health sciences
0302 clinical medicine
Internal medicine
Biomarkers, Tumor
Humans
Medicine
CTLA-4 Antigen
Melanoma
Aged
Proportional Hazards Models
Retrospective Studies
L-Lactate Dehydrogenase
Performance status
business.industry
Antibodies, Monoclonal
Cancer
Immunotherapy
Middle Aged
Prognosis
medicine.disease
Survival Analysis
Immune checkpoint
Eosinophils
C-Reactive Protein
Nivolumab
030104 developmental biology
030220 oncology & carcinogenesis
Regression Analysis
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 09598049
- Volume :
- 82
- Database :
- OpenAIRE
- Journal :
- European Journal of Cancer
- Accession number :
- edsair.doi.dedup.....78d279ca20694f3bc3d1e512bdff2881