دورية أكاديمية
Combined immunotherapy in melanoma patients with brain metastases: A multicenter international study
| العنوان: | Combined immunotherapy in melanoma patients with brain metastases: A multicenter international study |
|---|---|
| المؤلفون: | mandala, mario, Lorigan, Paul, Sergi, Maria Chiara, Benannoune, Naima, Serra, Patricio, Vitale, Maria Grazia, MUÑOZ COUSELO, EVA |
| المساهمون: | Institut Català de la Salut, Mandalà M Unit of Medical Oncology, University of Perugia, Perugia, Italy. Lorigan P, Serra P The University of Manchester, Oxford Rd, Manchester M13 9PL, UK. Sergi MC Medical Oncology Unit, Azienda Ospedaliero Universitaria Policlinico di Bari, Bari, Italy. Benannoune N Gustave Roussy Cancer Campus, Villejuif, France. Vitale MG Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, I.N.T. IRCCS Fondazione "G. Pascale" Napoli, Naples, Italy. Munoz Couselo E Servei d’Oncologia Mèdica, Vall d′Hebron Hospital, Barcelona, Spain. Vall d′Hebron Institute of Oncology (VHIO), Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus |
| المصدر: | Scientia |
| بيانات النشر: | Elsevier |
| سنة النشر: | 2024 |
| مصطلحات موضوعية: | Cervell - Càncer - Immunoteràpia, Melanoma - Immunoteràpia, DISEASES::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Germ Cell and Embryonal::Neuroectodermal Tumors::Neuroendocrine Tumors::Melanoma, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Biological Therapy::Immunomodulation::Immunotherapy, DISEASES::Neoplasms::Neoplasms by Site::Nervous System Neoplasms::Central Nervous System Neoplasms::Brain Neoplasms, ENFERMEDADES::neoplasias::neoplasias por tipo histológico::neoplasias de células germinales y embrionarias::tumores neuroectodérmicos::tumores neuroendocrinos::melanoma, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapia biológica::inmunomodulación::inmunoterapia, ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema nervioso::neoplasias del sistema nervioso central::neoplasias cerebrales |
| الوصف: | Brain metastases; Combined immunotherapy; Stereotactic radiosurgery ; Metàstasis cerebrals; Immunoteràpia combinada; Radiocirurgia estereotàctica ; Metástasis cerebrales; Inmunoterapia combinada; Radiocirugía estereotáxica ; Background Ipilimumab plus nivolumab (COMBO) is the standard treatment in asymptomatic patients with melanoma brain metastases (MBM). We report a retrospective study aiming to assess the outcome of patients with MBM treated with COMBO outside clinical trials. Methods Consecutive patients treated with COMBO have been included. Demographics, steroid treatment, Central Nervous System (CNS)-related symptoms, BRAF status, radiotherapy or surgery, response rate (RR), progression-free (PFS) and overall survival (OS) have been analyzed. Results 376 patients were included: 262 received COMBO as first-line and 114 as a subsequent line of therapy, respectively. In multivariate analysis, Eastern Cooperative Oncology Group (ECOG) (≥1 vs 0) [HR 1.97 (1.46–2.66)], extracerebral metastases [HR 1.92 (1.09–3.40)], steroid use at the start of COMBO [HR 1.59 (1.08–2.38)], CNS-related symptoms [HR 1.59 (1.08–2.34)], SRS (Stereotactic radiosurgery) [HR 0.63 (0.45–0.88)] and surgery [HR 0.63 (0.43–0.91)] were associated with OS. At a median follow-up of 30 months, the median OS (mOS) in the overall population was 21.3 months (18.1–24.5), whilst OS was not yet reached in treatment-naive patients, steroid-free at baseline. In patients receiving COMBO after BRAF/MEK inhibitors(i) PFS at 1-year was 15.7%. The dose of steroids (dexamethasone < vs ≥ 4 mg/day) was not prognostic. SRS alongside COMBO vs COMBO alone in asymptomatic patients prolonged survival. (p = 0.013). Toxicities were consistent with previous studies. An independent validation cohort (n = 51) confirmed the findings. Conclusions Our results demonstrate remarkable long-term survival in treatment-naïve, asymptomatic, steroid-free patients, as well as in those receiving SRS plus COMBO. PFS and OS were poor in patients receiving COMBO after progressing ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0959-8049 |
| العلاقة: | European Journal of Cancer;199; https://doi.org/10.1016/j.ejca.2024.113542Test; Mandalà M, Lorigan P, Sergi MC, Benannoune N, Serra P, Vitale MG, et al. Combined immunotherapy in melanoma patients with brain metastases: A multicenter international study. Eur J Cancer. 2024 Mar;199:113542.; https://hdl.handle.net/11351/11058Test |
| DOI: | 10.1016/j.ejca.2024.113542 |
| الإتاحة: | https://doi.org/10.1016/j.ejca.2024.113542Test https://hdl.handle.net/11351/11058Test |
| حقوق: | Attribution 4.0 International ; http://creativecommons.org/licenses/by/4.0Test/ ; info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.46C0CC4B |
| قاعدة البيانات: | BASE |
| تدمد: | 09598049 |
|---|---|
| DOI: | 10.1016/j.ejca.2024.113542 |