التفاصيل البيبلوغرافية
| العنوان: |
Features and Long-Term Outcomes of Stage IV Melanoma Patients Achieving Complete Response Under Anti-PD-1-Based Immunotherapy. |
| المؤلفون: |
Chatziioannou, Eftychia, Leiter, Ulrike, Thomas, Ioannis, Keim, Ulrike, Seeber, Olivia, Meiwes, Andreas, Boessenecker, Isabell, Gonzalez, Stephanie Sanchez, Torres, Francisco Merraz, Niessner, Heike, Sinnberg, Tobias, Forschner, Andrea, Flatz, Lukas, Amaral, Teresa |
| المصدر: |
American Journal of Clinical Dermatology; May2023, Vol. 24 Issue 3, p453-467, 15p |
| مصطلحات موضوعية: |
IMMUNE checkpoint inhibitors, MELANOMA, TUMOR classification, CANCER patients, TREATMENT effectiveness, DESCRIPTIVE statistics, PROGRESSION-free survival, TUMOR markers, IMMUNOTHERAPY, OVERALL survival, PROPORTIONAL hazards models |
| مستخلص: |
Background: Immune checkpoint inhibition (ICI) has changed the melanoma treatment spectrum. Few studies have examined the characteristics and long-term outcomes of patients achieving complete response (CR) under ICI. Materials and methods: We evaluated patients with unresectable stage IV melanoma treated with first-line ICI. The characteristics of those achieving CR were compared with those not achieving CR. Progression-free survival (PFS) and overall survival (OS) were assessed. Late-onset toxicities, response to second-line treatment, the prognostic value of clinicopathologic features, and blood markers were examined. Results: A total of 265 patients were included; 41 (15.5%) achieved CR, while 224 (84.5%) had progressive disease, stable disease, or partial response. At the therapy start, those who had CR were more likely to be older than 65 years of age (p = 0.013), have a platelet-to-lymphocyte ratio below 213 (p = 0.036), and have lower lactate dehydrogenase levels (p = 0.008) than those not achieving a CR. For those who discontinued therapy after CR, the median follow-up time after CR was 56 months (interquartile range [IQR] 52–58) and the median time from CR to therapy end was 10 months (IQR 1–17). Five-year PFS after CR was 79% and 5-year OS was 83%. Most complete responders had a normalization of S100 at the time of CR (p < 0.001). In simple Cox regression analysis, age below 77 years at CR (p = 0.04) was associated with better prognosis after CR. Eight patients received second-line ICI; disease control was seen in 63%. Late immune-related toxicities occurred in 25% of patients, most being cutaneous immune-related toxicities. Conclusions: Response, according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria, is, until now, the most important prognostic factor, and CR is a valid surrogate marker for long-term survival in patients treated with ICI. Our results highlight the importance of investigating the optimal therapy duration in complete responders. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
