The role of dacarbazine and temozolomide therapy after treatment with immune checkpoint inhibitors in malignant melanoma patients: A case series and meta-analysis.

Autor: Rydén V; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.; Department of Oncology, Uppsala University Hospital, Uppsala, Sweden., El-Naggar AI; Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.; Department of Oncology, Örebro University Hospital, Örebro, Sweden., Koliadi A; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.; Department of Oncology, Uppsala University Hospital, Uppsala, Sweden., Ladjevardi CO; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.; Department of Oncology, Uppsala University Hospital, Uppsala, Sweden., Digkas E; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.; Department of Oncology, Uppsala University Hospital, Uppsala, Sweden.; Department of Oncology, Eskilstuna, Sweden., Valachis A; Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.; Department of Oncology, Örebro University Hospital, Örebro, Sweden., Ullenhag GJ; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.; Department of Oncology, Uppsala University Hospital, Uppsala, Sweden.
Jazyk: angličtina
Zdroj: Pigment cell & melanoma research [Pigment Cell Melanoma Res] 2024 May; Vol. 37 (3), pp. 352-362. Date of Electronic Publication: 2023 Dec 29.
DOI: 10.1111/pcmr.13156
Abstrakt: Dacarbazine (DTIC) and its oral counterpart temozolomide (TMZ) have been the most used agents in advanced malignant melanoma (MM) patients and they are still used routinely. The preferred first line treatment, immune checkpoint inhibitors (CPIs) might shape the tumor and the tumor microenvironment, possibly affecting the response to subsequent therapies. The aim of this study was to investigate the treatment effect of DTIC/TMZ in MM patients after CPI therapy in a consecutive patient cohort and through systematic literature review and meta-analysis. Thirty-five patients with advanced MM treated with DTIC/TMZ after previous CPI therapy in three Swedish regions between 2017 and 2021 were recognized and seven case series studies were identified through systematic database review. Pooled data from all 345 patients showed a median real-world progression-free survival (rwPFS) of 1.9 months and overall survival (OS) of 6.0 months. Three of these studies were included in a meta-analysis comparing DTIC/TMZ after CPI treatment, versus no previous immunotherapy, showing no statistically significant differences in rwPFS or OS but higher real-world response rate to chemotherapy for the prior-CPI treated group (Odds Ratio: 2.24; 95% Confidence Interval: 1.04-4.86). The current study supports consideration of DTIC/TMZ in later line of treatment in the immunotherapy era.
(© 2023 The Authors. Pigment Cell & Melanoma Research published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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