根据转移性黑色素瘤患者疾病进展和生存的实际情况,评估联合和单药免疫疗法的疗效。

IF 1.5 4区 医学 Q3 DERMATOLOGY Melanoma Research Pub Date : 2024-04-01 Epub Date: 2024-01-04 DOI:10.1097/CMR.0000000000000945
Brian Ko, Kevin Tao, Lachlan Brennan, Swanand Rakhade, Cynthia X Chan, Jee-Young Moone, Richard Zhu, Ariel Sher, Samuel Wang, Yadriel Bracero, Ben Fullerton, Beth McLellan, Larisa J Geskin, Yvonne M Saenger
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引用次数: 0

摘要

目的:描述真实世界中接受联合和单药免疫疗法的转移性黑色素瘤患者在临床试验之外的生存结果。我们对实际环境中的转移性黑色素瘤患者进行了一项单机构回顾性研究。生存率采用对数秩检验进行计算。或然率表采用费雪精确检验进行分析。CD8 + T细胞密度采用定量免疫荧光法测定,并用曼-惠特尼U检验进行分析。132例患者的中位总生存期(OS)为45.3个月。与肝病和/或骨病相比,脑转移并不会带来更高的死亡风险(分别为39.53个月和30.00个月;P = 0.687)。49.2%的患者接受了抗PD-1单药治疗,这是最常见的一线治疗方法。接受单药抗PD-1治疗和抗PD-1加CTLA-4联合治疗的患者在OS方面没有明显差异(39.4个月对未确定;P = 0.643)。与接受单一疗法的患者相比,接受联合疗法的患者在最后一次随访时无进展存活的几率更高(70.4% 对 49.2%;P = 0.0408)。抗PD-1单药治疗后开始二线治疗的中位OS为21.8个月。接受一线免疫疗法后病情得到控制的患者 CD8+ T 细胞密度更高(P = 0.013)。在现实世界中,转移性黑色素瘤患者的生存率非常高,即使在一线治疗进展后也能获得治疗效果。在现实世界中,联合免疫疗法可能会产生更有利的长期疗效。治疗前高CD8+ T细胞浸润与免疫疗法的疗效相关。
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Evaluating the efficacy of combination and single-agent immunotherapies in real-world patterns of disease progression and survival of metastatic melanoma patients.

The objective of this study is to describe survival outcomes in patients with metastatic melanoma in a real-world setting receiving combination and single-agent immunotherapy outside the clinical trial context. We conducted a retrospective single-institution study of patients with metastatic melanoma in a real-world setting. Survival was calculated using log-rank test. Contingency tables were analyzed using Fisher's Exact test. CD8 + T-cell densities were measured using quantitative immunofluorescence and analyzed using Mann-Whitney U test. The median overall survival (OS) for 132 patients was 45.3 months. Brain metastasis did not confer a higher risk of death relative to liver and/or bone disease (39.53 versus 30.00 months, respectively; P  = 0.687). Anti-PD-1 monotherapy was the most common first-line treatment, received by 49.2% of patients. There was no significant difference in OS between patients receiving single-agent anti-PD-1 and combination anti-PD-1 plus CTLA-4 (39.4 months versus undefined; P  = 0.643). Patients treated with combination therapy were more likely to be alive without progression at the last follow-up than those who received monotherapy (70.4% versus 49.2%; P  = 0.0408). Median OS was 21.8 months after initiation of second-line therapy after anti-PD-1 monotherapy. CD8+ T-cell densities were higher in patients who achieved disease control on first-line immunotherapy ( P  = 0.013). In a real-world setting, patients with metastatic melanoma have excellent survival rates, and treatment benefit can be achieved even after progression on first-line therapy. Combination immunotherapy may produce more favorable long-term outcomes in a real-world setting. High pretreatment CD8+ T-cell infiltration correlates with immunotherapy efficacy.

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来源期刊
Melanoma Research
Melanoma Research 医学-皮肤病学
CiteScore
3.40
自引率
4.50%
发文量
139
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Melanoma Research is a well established international forum for the dissemination of new findings relating to melanoma. The aim of the Journal is to promote the level of informational exchange between those engaged in the field. Melanoma Research aims to encourage an informed and balanced view of experimental and clinical research and extend and stimulate communication and exchange of knowledge between investigators with differing areas of expertise. This will foster the development of translational research. The reporting of new clinical results and the effect and toxicity of new therapeutic agents and immunotherapy will be given emphasis by rapid publication of Short Communications. ​Thus, Melanoma Research seeks to present a coherent and up-to-date account of all aspects of investigations pertinent to melanoma. Consequently the scope of the Journal is broad, embracing the entire range of studies from fundamental and applied research in such subject areas as genetics, molecular biology, biochemistry, cell biology, photobiology, pathology, immunology, and advances in clinical oncology influencing the prevention, diagnosis and treatment of melanoma.
期刊最新文献
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