Outcomes With Postrecurrence Systemic Therapy Following Adjuvant Checkpoint Inhibitor Treatment for Resected Melanoma in CheckMate 238.

Autor:	Weber J; Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, NY., Del Vecchio M; Unit of Melanoma Medical Oncology, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Mandalá M; Papa Giovanni XIII Hospital, Bergamo, Italy., Gogas H; Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece., Arance AM; Department of Medical Oncology, Hospital Clínic de Barcelona-IDIBAPS, Barcelona, Spain., Dalle S; Department of Dermatology, Hospices Civils de Lyon, Pierre Bénite, France., Cowey CL; Department of Medical Oncology, Texas Oncology-Baylor Charles A Sammons Cancer Center, Dallas, TX., Schenker M; Oncology Center Sf Nectarie, Craiova, Romania., Grob JJ; Department of Dermatology, Aix-Marseille University, Hôpital de la Timone, Marseille, France., Chiarion-Sileni V; Melanoma Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy., Márquez-Rodas I; Department of Medical Oncology, General University Hospital Gregorio Marañón and CIBERONC, Madrid, Spain., Butler MO; Department of Medical Oncology and Hematology, Department of Medicine, Department of Immunology University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada., Di Giacomo AM; Center for Immuno-Oncology, University Hospital of Siena, Siena, University of Siena, Italy., de la Cruz-Merino L; 4Department of Clinical Oncology, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla, Hospital University Virgen Macarena, Seville, Spain., Arenberger P; 5Department of Dermatology, Charles University Third Faculty of Medicine and University Hospital Kralovske Vinohrady, Prague, Czech Republic., Atkinson V; 6Division of Cancer Services, Gallipoli Medical Research Foundation, University of Queensland, Brisbane, QLD, Australia., Hill A; 7Department of Medical Oncology, Tasman Health Care, Southport, QLD, Australia., Fecher LA; 8Division of Hematology-Oncology, Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, MI., Millward M; Department of Internal Medicine, University of Western Australia and Sir Charles Gairdner Hospital, Nedlands, WA, Australia., Khushalani NI; 0Department of Cutaneous Oncology, H Lee Moffitt Cancer Center, Tampa, FL., Queirolo P; 1Medical Oncology of Melanoma, Sarcoma and Rare Tumors, IEO European Institute of Oncology IRCCS, Milan, Italy., Long GV; 2Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, NSW, Australia., Lobo M; 3Oncology Clinical Development, Bristol Myers Squibb, Princeton, NJ., Askelson M; 3Oncology Clinical Development, Bristol Myers Squibb, Princeton, NJ., Ascierto PA; Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, Italy., Larkin J; Department of Medical Oncology, The Royal Marsden NHS Foundation Trust, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2024 Nov; Vol. 42 (31), pp. 3702-3712. Date of Electronic Publication: 2024 Aug 05.
DOI:	10.1200/JCO.23.01448
Abstrakt:	Purpose: In phase III CheckMate 238, adjuvant nivolumab significantly improved recurrence-free survival compared with ipilimumab in patients with resected stage IIIB-C/IV melanoma without a significant difference in overall survival (OS). Here, we investigate progression-free survival (PFS) and OS after postrecurrence systemic therapy. Patients and Methods: Patients 15 years or older with resected stage IIIB-C/IV melanoma were stratified by stage and tumor PD-L1 status and randomly assigned to receive nivolumab 3 mg/kg every 2 weeks, or ipilimumab 10 mg/kg every 3 weeks for four doses and then every 12 weeks for 1 year or until disease recurrence, unacceptable toxicity, or withdrawal of consent. Patients with recurrence in each group were assessed for PFS and OS from subsequent systemic therapy (SST) initiation per recurrence timing (≤12 months [early] v >12 months [late] from initial therapy). Results: Recurrences occurred in 198 (44%) of 453 nivolumab-treated patients (122 early, 76 late) and 232 (51%) of 453 ipilimumab-treated patients (160 early, 72 late). Median PFS on next-line systemic therapy for nivolumab-treated patients recurring early versus late was 4.7 versus 12.4 months (24-month rates, 16% v 31%); median OS was 19.8 versus 42.8 months (24-month rates: 37% v 73%). In response to subsequent therapy, patients on nivolumab with late versus early recurrence were more likely to benefit from anti-PD-1 monotherapy. Nivolumab-treated patients with either an early or late recurrence benefitted from an ipilimumab-based therapy or targeted therapy, each with similar OS. Conclusion: Postrecurrence survival was longer for patients who recurred >12 months. Patients on nivolumab who recurred early benefitted from SST but had better survival with ipilimumab-based regimens or targeted therapy compared with anti-PD-1 monotherapy.
Databáze:	MEDLINE
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