Improved overall survival in dual compared to single immune checkpoint inhibitors in BRAF V600-negative advanced melanoma

IF 1 Q4 ONCOLOGY Melanoma Management Pub Date : 2022-03-01 DOI:10.2217/mmt-2021-0005

A. Kartolo, Cynthia Yeung, M. Kuksis, W. Hopman, T. Baetz

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引用次数: 1

Abstract

Aim: To evaluate the efficacy of dual versus single immune checkpoint inhibitors (ICI) in BRAF wild-type advanced melanoma patients. Materials & methods: A retrospective study of all advanced BRAF wild-type melanoma patients on palliative-intent ICI between 2015 and 2020 (n = 67). Results: Dual ICI had better overall survival (OS) when compared with single ICI in BRAF wild-type patients (hazard ratio: 0.204; 95% CI: 0.064–0.649; p = 0.007), but lost its statistical significance (median OSl not reached vs 20.9 months; p = 0.213; adjusted hazard ratio: 0.475; 95% CI: 0.164–1.380; p = 0.171) when only including patients treated after 2018 when dual ICI was funded in our province. Dual ICI were significantly associated with more frequent (p = 0.005) and severe (p = 0.026) immune-related adverse events, and required more immune-related adverse events-indicated systemic corticosteroid use (p < 0.001) compared with single ICI. Conclusion: While limited by small sample size and retrospective nature, dual ICI may have non statistically significant trend toward better OS efficacy when compared with single ICI in BRAF V600 wild-type advanced melanoma patients.

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BRAF V600阴性晚期黑色素瘤双免疫检查点抑制剂与单免疫检查点抑制物相比总生存率提高

目的：评价双重与单一免疫检查点抑制剂（ICI）对BRAF野生型晚期黑色素瘤患者的疗效。材料与方法：对2015年至2020年间所有晚期BRAF野生型黑色素瘤患者进行姑息性ICI的回顾性研究（n=67）。结果：在BRAF野生型患者中，与单一ICI相比，双重ICI具有更好的总生存率（OS）（危险比：0.204；95%CI:0.064–0.649；p=0.007），但当仅包括2018年后在我省资助双ICI时接受治疗的患者时，失去了统计学意义（OSl中位数未达到20.9个月；p=0.213；调整后的风险比：0.475；95%CI:0.164–1.380；p=0.171）。与单一ICI相比，双重ICI与更频繁（p=0.005）和更严重（p=0.026）的免疫相关不良事件显著相关，并且需要更多的免疫相关的不良事件，表明全身使用皮质类固醇（p<0.001）。结论：虽然受小样本量和回顾性的限制，但在BRAF V600野生型晚期黑色素瘤患者中，与单一ICI相比，双重ICI可能具有更好的OS疗效的无统计学意义的趋势。

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来源期刊

Melanoma Management ONCOLOGY-

CiteScore

5.10

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： Skin cancer is on the rise. According to the World Health Organization, 132,000 melanoma skin cancers occur globally each year. While early-stage melanoma is usually relatively easy to treat, once disease spreads prognosis worsens considerably. Therefore, research into combating advanced-stage melanoma is a high priority. New and emerging therapies, such as monoclonal antibodies, B-RAF and KIT inhibitors, antiangiogenic agents and novel chemotherapy approaches hold promise for prolonging survival, but the search for a cure is ongoing. Melanoma Management publishes high-quality peer-reviewed articles on all aspects of melanoma, from prevention to diagnosis and from treatment of early-stage disease to late-stage melanoma and metastasis. The journal presents the latest research findings in melanoma research and treatment, together with authoritative reviews, cutting-edge editorials and perspectives that highlight hot topics and controversy in the field. Independent drug evaluations assess newly approved medications and their role in clinical practice. Key topics covered include: Risk factors, prevention and sun safety education Diagnosis, staging and grading Surgical excision of melanoma lesions Sentinel lymph node biopsy Biological therapies, including immunotherapy and vaccination Novel chemotherapy options Treatment of metastasis Prevention of recurrence Patient care and quality of life.