TY - JOUR
T1 - Immune checkpoint blockade for metastatic uveal melanoma
T2 - Patterns of response and survival according to the presence of hepatic and extrahepatic metastasis
AU - German Dermatologic Cooperative Oncology Group (DeCOG Committee Ocular Melanoma)
AU - Koch, Elias A.T.
AU - Petzold, Anne
AU - Wessely, Anja
AU - Dippel, Edgar
AU - Gesierich, Anja
AU - Gutzmer, Ralf
AU - Hassel, Jessica C.
AU - Haferkamp, Sebastian
AU - Hohberger, Bettina
AU - Kähler, Katharina C.
AU - Knorr, Harald
AU - Kreuzberg, Nicole
AU - Leiter, Ulrike
AU - Loquai, Carmen
AU - Meier, Friedegund
AU - Meissner, Markus
AU - Mohr, Peter
AU - Pföhler, Claudia
AU - Rahimi, Farnaz
AU - Schadendorf, Dirk
AU - Schell, Beatrice
AU - Schlaak, Max
AU - Terheyden, Patrick
AU - Thoms, Kai Martin
AU - Schuler-Thurner, Beatrice
AU - Ugurel, Selma
AU - Ulrich, Jens
AU - Utikal, Jochen
AU - Weichenthal, Michael
AU - Ziller, Fabian
AU - Berking, Carola
AU - Heppt, Markus V.
N1 - Publisher Copyright:
Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Background: Since there is no standardized and effective treatment for advanced uveal melanoma (UM), the prognosis is dismal once metastases develop. Due to the availability of immune checkpoint blockade (ICB) in the real-world setting, the prognosis of metastatic UM has improved. However, it is unclear how the presence of hepatic and extrahepatic metastasis impacts the response and survival after ICB. Methods: A total of 178 patients with metastatic UM treated with ICB were included in this analysis. Patients were recruited from German skin cancer centers and the German national skin cancer registry (ADOReg). To investigate the impact of hepatic metastasis, two cohorts were compared: patients with liver metastasis only (cohort A, n = 55) versus those with both liver and extra-hepatic metastasis (cohort B, n = 123). Data were analyzed in both cohorts for response to treatment, progression-free survival (PFS), and overall survival (OS). The survival and progression probabilities were calculated with the Kaplan–Meier method. Log-rank tests, χ2 tests, and t-tests were performed to detect significant differences between both cohorts. Results: The median OS of the overall population was 16 months (95% CI 13.4–23.7) and the median PFS, 2.8 months (95% CI 2.5–3.0). The median OS was longer in cohort B than in cohort A (18.2 vs. 6.1 months; p = 0.071). The best objective response rate to dual ICB was 13.8% and to anti-PD-1 monotherapy 8.9% in the entire population. Patients with liver metastases only had a lower response to dual ICB, yet without significance (cohort A 8.7% vs. cohort B 16.7%; p = 0.45). Adverse events (AE) occurred in 41.6%. Severe AE were observed in 26.3% and evenly distributed between both cohorts. Conclusion: The survival of this large cohort of patients with advanced UM was more favorable than reported in previous benchmark studies. Patients with both hepatic and extrahepatic metastasis showed more favorable survival and higher response to dual ICB than those with hepatic metastasis only.
AB - Background: Since there is no standardized and effective treatment for advanced uveal melanoma (UM), the prognosis is dismal once metastases develop. Due to the availability of immune checkpoint blockade (ICB) in the real-world setting, the prognosis of metastatic UM has improved. However, it is unclear how the presence of hepatic and extrahepatic metastasis impacts the response and survival after ICB. Methods: A total of 178 patients with metastatic UM treated with ICB were included in this analysis. Patients were recruited from German skin cancer centers and the German national skin cancer registry (ADOReg). To investigate the impact of hepatic metastasis, two cohorts were compared: patients with liver metastasis only (cohort A, n = 55) versus those with both liver and extra-hepatic metastasis (cohort B, n = 123). Data were analyzed in both cohorts for response to treatment, progression-free survival (PFS), and overall survival (OS). The survival and progression probabilities were calculated with the Kaplan–Meier method. Log-rank tests, χ2 tests, and t-tests were performed to detect significant differences between both cohorts. Results: The median OS of the overall population was 16 months (95% CI 13.4–23.7) and the median PFS, 2.8 months (95% CI 2.5–3.0). The median OS was longer in cohort B than in cohort A (18.2 vs. 6.1 months; p = 0.071). The best objective response rate to dual ICB was 13.8% and to anti-PD-1 monotherapy 8.9% in the entire population. Patients with liver metastases only had a lower response to dual ICB, yet without significance (cohort A 8.7% vs. cohort B 16.7%; p = 0.45). Adverse events (AE) occurred in 41.6%. Severe AE were observed in 26.3% and evenly distributed between both cohorts. Conclusion: The survival of this large cohort of patients with advanced UM was more favorable than reported in previous benchmark studies. Patients with both hepatic and extrahepatic metastasis showed more favorable survival and higher response to dual ICB than those with hepatic metastasis only.
UR - http://www.scopus.com/inward/record.url?scp=85111786780&partnerID=8YFLogxK
U2 - 10.3390/cancers13133359
DO - 10.3390/cancers13133359
M3 - Journal articles
AN - SCOPUS:85111786780
SN - 2072-6694
VL - 13
JO - Cancers
JF - Cancers
IS - 13
M1 - 3359
ER -
