التفاصيل البيبلوغرافية
| العنوان: |
Combined immunotherapy in melanoma patients with brain metastases: A multicenter international study. |
| المؤلفون: |
Mandalà, Mario1 (AUTHOR) mario.mandala@unipg.it, Lorigan, Paul1,2 (AUTHOR), Sergi, Maria Chiara3 (AUTHOR), Benannoune, Naima4 (AUTHOR), Serra, Patricio2 (AUTHOR), Vitale, Maria Grazia5 (AUTHOR), Giannarelli, Diana6 (AUTHOR), Arance, Ana Maria7 (AUTHOR), Couselo, Eva Munoz8 (AUTHOR), Neyns, Bart9 (AUTHOR), Tucci, Marco3 (AUTHOR), Guida, Michele10 (AUTHOR), Spagnolo, Francesco11 (AUTHOR), Rossi, Ernesto12 (AUTHOR), Occelli, Marcella13 (AUTHOR), Queirolo, Paola14 (AUTHOR), Quaglino, Pietro15 (AUTHOR), Depenni, Roberta16 (AUTHOR), Merelli, Barbara17 (AUTHOR), Placzke, Joanna18 (AUTHOR) |
| المصدر: |
European Journal of Cancer. Mar2024, Vol. 199, pN.PAG-N.PAG. 1p. |
| مصطلحات موضوعية: |
*MELANOMA prognosis, *THERAPEUTIC use of antineoplastic agents, *DRUG efficacy, *RESEARCH, *MELANOMA, *MULTIVARIATE analysis, *DEXAMETHASONE, *IPILIMUMAB, *METASTASIS, *RETROSPECTIVE studies, *BRAIN tumors, *CANCER patients, *NEUROLOGIC manifestations of general diseases, *NIVOLUMAB, *DESCRIPTIVE statistics, *PROGRESSION-free survival, *RADIOSURGERY, *IMMUNOTHERAPY, *OVERALL survival, *PROPORTIONAL hazards models, *EVALUATION |
| مستخلص: |
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. 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. 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. 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 to BRAF/MEKi. • Median OS was not reached in asymptomatic/steroid free pts with MBM receiving COMBO. • Patients receiving COMBO after BRAF/MEKi show a poor prognosis. • The dose of steroids during COMBO is not prognostic. • SRS given during COMBO is associated with improved survival. • Long-lasting responses can be maintained after treatment interruption. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
Academic Search Index |
