Toripalimab (anti-PD-1) versus high-dose interferon-α2b as adjuvant therapy in resected mucosal melanoma: a phase II randomized trial.

Autor:	Lian B; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Si L; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Chi ZH; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Sheng XN; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Kong Y; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Wang X; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Tian H; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Li K; Department of Cancer Biotherapy Center, Yunnan Cancer Hospital, Kunming, The Third Affiliated Hospital of Kunming Medical University, Kunming, China., Mao LL; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Bai X; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Tang BX; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Yan XQ; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Li SM; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Zhou L; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Dai J; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Tang XW; Shanghai Junshi Biosciences, Shanghai, China., Ran FW; Shanghai Junshi Biosciences, Shanghai, China., Yao S; Shanghai Junshi Biosciences, Shanghai, China., Guo J; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China., Cui CL; Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China. Electronic address: 1008ccl@163.com.
Jazyk:	angličtina
Zdroj:	Annals of oncology : official journal of the European Society for Medical Oncology [Ann Oncol] 2022 Oct; Vol. 33 (10), pp. 1061-1070. Date of Electronic Publication: 2022 Jul 14.
DOI:	10.1016/j.annonc.2022.07.002
Abstrakt:	Background: No standard of care for mucosal melanoma (MM) in the adjuvant setting has been established. Meanwhile, relapse-free survival (RFS) is only ∼5 months after surgery alone. This phase II trial aimed to compare toripalimab versus high-dose interferon-α2b (HDI) as an adjuvant therapy for resected MM. Patients and Methods: From July 2017 to May 2019, 145 patients with resected MM were randomized (1 : 1) to receive HDI (n = 72) or toripalimab (n = 73) for 1 year until disease relapse/distant metastasis, unacceptable toxicity, or withdrawal of consent. The primary endpoint was RFS. The secondary endpoints included distant metastasis-free survival (DMFS), overall survival (OS), and safety. Results: After a median follow-up of 26.3 months, the number of RFS, OS, and DMFS events was 51 versus 46, 33 versus 29, and 49 versus 44 in the toripalimab arm and the HDI arm, respectively. The median RFS was 13.6 [95% confidence interval (CI) 8.31-19.02] months and 13.9 (95% CI 8.28-19.61) months in the toripalimab arm and the HDI arm, respectively. The DMFS was not significantly different between the two arms [hazard ratio (HR) 1.00; 95% CI 0.65-1.54]. The median OS was 35.1 months (95% CI 27.93 months-not reached) in the toripalimab arm, with no significant difference in all-cause death (HR 1.11, 95% CI 0.66-1.84) for the two arms. The median sums of the patients' actual infusion doses were 3672 mg and 1054.5 MIU in the toripalimab arm and the HDI arm, respectively. The incidence of treatment-emergent adverse events with a grade ≥3 was much higher in the HDI arm than in the toripalimab arm (87.5% versus 27.4%). Conclusions: Toripalimab showed a similar RFS and a more favorable safety profile than HDI, both better than historical data, suggesting that toripalimab might be the better treatment option. However, additional translational studies and better treatment regimens are still warranted to improve the clinical outcome of MM. Competing Interests: Disclosure JG is a member of the advisory board/consultant of MSD, Roche, Pfizer, Bayer, Novartis, Simcere, Shanghai Junshi Bioscience, and Oriengene. XT, FR, and SY are employees of Shanghai Junshi Biosciences Co. Ltd. All other authors have declared no conflicts of interest. Data sharing The datasets generated and analyzed in the present study are available from the sponsor upon reasonable request. (Copyright © 2022. Published by Elsevier Ltd.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu