Clinical determinants of long-term survival in metastatic uveal melanoma

Elias A.T. Koch, Anne Petzold, Anja Wessely, Edgar Dippel, Michael Erdmann, Lucie Heinzerling, Bettina Hohberger, Harald Knorr, Ulrike Leiter, Friedegund Meier, Peter Mohr, Farnaz Rahimi, Beatrice Schell, Max Schlaak, Patrick Terheyden, Beatrice Schuler-Thurner, Selma Ugurel, Jochen Utikal, Julio Vera, Michael WeichenthalFabian Ziller, Carola Berking, Markus V. Heppt*

*Corresponding author for this work
10 Citations (Scopus)

Abstract

This study aimed to identify prognostic factors in patients with metastatic uveal melanoma (UM) that were associated with long-term survival in a real-world setting. A total of 94 patients with metastatic UM were included from German skin cancer centers and the German national skin cancer registry (ADOReg). Data were analyzed for the response to treatment, progression-free survival, and overall survival (OS). Prognostic factors were explored with univariate Cox regression, log-rank, and χ2-tests. Identified factors were subsequently validated after the population was divided into two cohorts of short-term survival (< 2 years OS, cohort A, n = 50) and long-term survival (> 2 years OS, cohort B, n = 44). A poor ECOG performance status (hazard ratio [HR] 2.0, 95% confidence interval [CI] 1.0–3.9) and elevated serum LDH (HR 2.0, 95% CI 1.0–3.8) were associated with a poor OS, whereas a good response to immune checkpoint blockade (ICB, p < 0.001), radiation therapy (p < 0.001), or liver-directed treatments (p = 0.01) were associated with a prolonged OS. Long-term survivors (cohort B) showed a higher median number of organs affected by metastasis (p < 0.001), while patients with liver metastases only were more common in cohort A (40% vs. 9%; p = 0.002). A partial response to ICB was observed in 16% (12/73), being 21% (8/38) for combined ICB, 17% (1/6) for single CTLA4 inhibition, and 10% (3/29) for single PD1 inhibition. One complete response occurred in cohort B with combined ICB. We conclude that the response to ICB and the presence of extrahepatic disease were favorable prognostic factors for long-term survival.

Original languageEnglish
JournalCancer Immunology, Immunotherapy
Volume71
Issue number6
Pages (from-to)1467-1477
Number of pages11
ISSN0340-7004
DOIs
Publication statusPublished - 06.2022

Research Areas and Centers

  • Academic Focus: Center for Infection and Inflammation Research (ZIEL)

DFG Research Classification Scheme

  • 204-05 Immunology
  • 205-19 Dermatology
  • 205-14 Haematology, Oncology

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