التفاصيل البيبلوغرافية
| العنوان: |
Differential gradients of immunotherapy vs targeted therapy efficacy according to the sun-exposure pattern of the site of occurrence of primary melanoma: a multicenter prospective cohort study (MelBase). |
| المؤلفون: |
Russo, David, Dalle, Stéphane, Dereure, Olivier, Mortier, Laurent, Dalac-Rat, Sophie, Dutriaux, Caroline, Leccia, Marie-Thérèse, Legoupil, Delphine, Montaudié, Henri, Maubec, Eve, De Quatrebarbes, Julie, Arnault, Jean-Philippe, Brocard, Florence Granel, Saïag, Philippe, Dreno, Brigitte, Allayous, Clara, Oriano, Bastien, Lefevre, Wendy, Lebbé, Céleste, Boussemart, Lise |
| المصدر: |
Frontiers in Oncology; 2023, p1-9, 9p |
| مصطلحات موضوعية: |
MELANOMA, IMMUNOTHERAPY, COHORT analysis, LONGITUDINAL method, PROGRESSION-free survival |
| مستخلص: |
Background: The tumor mutational burden (TMB) is high in melanomas owing to UV-induced oncogenesis. While a high TMB is a predictive biomarker of response to PD-1 inhibitors, it may be associated with the rise of resistant clones to targeted therapy over time. We hypothesized that survivals may depend on both the sun-exposure profile of the site of primary melanoma and the type of systemic treatment. Patients and methods: Patients were screened from MelBase, a multicenter biobank dedicated to the prospective follow-up of stage III/IV melanoma. All systemic treatment by immunotherapy or targeted therapy were included (2013- 2019). Outcomes were progression-free survival (PFS) and overall survival (OS). Results: 973 patients received either anti PD-1(n=466), anti CTLA-4(n=143), a combination of both (n=118), or targeted therapies (n=246). Patients’ characteristics at treatment initiation were: male (62%), median age of 62, AJCC stage IV (84%). Median follow-up was 15.5 months. The primary melanoma was located on chronically sun-exposed skin in 202 patients (G1: head neck), on intermittently sun-exposed skin in 699 patients (G2: trunk, arms, legs), and on sun-protected areas in 72 patients (G3: palms, soles). Median PFS was significantly higher in G1 under anti PD-1 treatment (8.7 months vs 3.3 and 3.4 months for G2 and G3, respectively) (p=0.011). PFS did not significantly differ in other groups. Similarly, median OS was significantly higher in G1 receiving 1st line anti PD-1 treatment (45.6 months vs 31.6 and 21.4 months for G2 and G3) (p=0.04), as opposed to 1st line targeted therapy (19.5 months vs 16.3 and 21.1 months for G1, G2 and G3 respectively). Conclusion: Our study confirms that immunotherapy with anti PD-1 is particularly recommended for melanomas originating from chronically sunexposed areas, but this finding needs to be confirmed by further research. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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