The efficacy of immune checkpoint blockade for melanoma in-transit with or without nodal metastases - a multicenter cohort study.
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Holmberg, Carl-JacobNy, Lars
Hieken, Tina J
Block, Matthew S
Carr, Michael J
Sondak, Vernon K
Örtenwall, Christoffer
Katsarelias, Dimitrios
Dimitriou, Florentia
Menzies, Alexander M
Saw, Robyn Pm
Rogiers, Aljosja
Straker, Richard J
Karakousis, Giorgos
Applewaite, Rona
Pallan, Lalit
Han, Dale
Vetto, John T
Gyorki, David E
Tie, Emilia Nan
Vitale, Maria Grazia
Ascierto, Paulo A
Dummer, Reinhard
Cohen, Jade
Hui, Jane Yc
Schachter, Jacob
Asher, Nethanel
Helgadottir, H
Chai, Harvey
Kroon, Hidde
Coventry, Brendon
Rothermel, Luke D
Sun, James
Carlino, Matteo S
Duncan, Zoey
Broman, Kristy
Weber, Jeffrey
Lee, Ann Y
Berman, Russell S
Teras, Jüri
Ollila, David W
Long, Georgina V
Zager, Jonathan S
van Akkooi, Alexander
Olofsson Bagge, Roger
Publication date
2022-05-26Subject
Oncology
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Purpose: Guidelines addressing melanoma in-transit metastasis (ITM) recommend immune checkpoint inhibitors (ICI) as a first-line treatment option, despite the fact that there are no efficacy data available from prospective trials for exclusively ITM disease. The study aims to analyze the outcome of patients with ITM treated with ICI based on data from a large cohort of patients treated at international referral clinics. Methods: A multicenter retrospective cohort study of patients treated between January 2015 and December 2020 from Australia, Europe, and the USA, evaluating treatment with ICI for ITM with or without nodal involvement (AJCC8 N1c, N2c, and N3c) and without distant disease (M0). Treatment was with PD-1 inhibitor (nivolumab or pembrolizumab) and/or CTLA-4 inhibitor (ipilimumab). The response was evaluated according to the RECIST criteria modified for cutaneous lesions. Results: A total of 287 patients from 21 institutions in eight countries were included. Immunotherapy was first-line treatment in 64 (22%) patients. PD-1 or CTLA-4 inhibitor monotherapy was given in 233 (81%) and 23 (8%) patients, respectively, while 31 (11%) received both in combination. The overall response rate was 56%, complete response (CR) rate was 36%, and progressive disease (PD) rate was 32%. Median PFS was ten months (95% CI 7.4-12.6 months) with a one-, two-, and five-year PFS rate of 48%, 33%, and 18%, respectively. Median MSS was not reached, and the one-, two-, and five-year MSS rates were 95%, 83%, and 71%, respectively. Conclusion: Systemic immunotherapy is an effective treatment for melanoma ITM. Future studies should evaluate the role of systemic immunotherapy in the context of multimodality therapy, including locoregional treatments such as surgery, intralesional therapy, and regional therapies.Citation
Holmberg CJ, Ny L, Hieken TJ, Block MS, Carr MJ, Sondak VK, Örtenwall C, Katsarelias D, Dimitriou F, Menzies AM, Saw RP, Rogiers A, Straker RJ 3rd, Karakousis G, Applewaite R, Pallan L, Han D, Vetto JT, Gyorki DE, Tie EN, Vitale MG, Ascierto PA, Dummer R, Cohen J, Hui JY, Schachter J, Asher N, Helgadottir H, Chai H, Kroon H, Coventry B, Rothermel LD, Sun J, Carlino MS, Duncan Z, Broman K, Weber J, Lee AY, Berman RS, Teras J, Ollila DW, Long GV, Zager JS, van Akkooi A, Olofsson Bagge R. The efficacy of immune checkpoint blockade for melanoma in-transit with or without nodal metastases - A multicenter cohort study. Eur J Cancer. 2022 Jul;169:210-222. doi: 10.1016/j.ejca.2022.03.041. Epub 2022 May 26Type
ArticleAdditional Links
https://www.sciencedirect.com/journal/european-journal-of-cancerPMID
35644725Journal
European Journal of CancerPublisher
Elsevierae974a485f413a2113503eed53cd6c53
10.1016/j.ejca.2022.03.041