Weekly carboplatin plus paclitaxel chemotherapy in advanced melanoma patients resistant to anti-PD-1 inhibitors: a retrospective, monocentric experience.

Autor: Di Pietro FR; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Marinelli D; Department of Experimental Medicine, Sapienza University, Rome, Italy., Verkhovskaia S; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Poti G; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Falcone R; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Carbone ML; Clinical Trial Center, IDI-IRCCS, Rome, Italy. marialuigia.carbone@idi.it., Morelli MF; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Zappalà AR; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Di Rocco ZC; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Morese R; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Piesco G; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Chesi P; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Marchetti P; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy., Failla CM; Experimental Immunology Laboratory, IDI-IRCCS, Rome, Italy., De Galitiis F; Department of Oncology and Dermatological Oncology, IDI-IRCCS, Rome, Italy.
Jazyk: angličtina
Zdroj: BMC cancer [BMC Cancer] 2024 Oct 01; Vol. 24 (1), pp. 1220. Date of Electronic Publication: 2024 Oct 01.
DOI: 10.1186/s12885-024-12961-9
Abstrakt: Immunotherapy with anti-PD-1 antibodies significantly improved the prognosis in advanced melanoma patients, but most of them develop primary or secondary resistance to the treatment. In this study, we evaluated efficacy and safety of a chemotherapy regimen with weekly carboplatin plus paclitaxel (wCP) in patients previously treated with anti-PD-1 antibodies. We retrospectively identified 30 patients with advanced melanoma treated at our Institute over the last eight years with wCP. The co-primary endpoints of the study were overall survival (OS) and progression-free survival (PFS). In addition, we evaluated treatment tolerability. For this patient cohort, median PFS and OS were 3.25 and 7.69 months, respectively. All included patients had previously received anti-PD-1 immunotherapy, most of them had ECOG PS 0-1, and only 5 patients had a BRAF V600 mutation. In univariable analysis, we observed shorter OS in patients with > 2 involved metastatic sites, superficial spreading histology, and serum lactate dehydrogenase (LDH) values above the median. Liver metastases were associated with worse outcomes, while radiotherapy treatment of brain metastases was associated with improved OS. However, in a multivariable Cox regression model, only LDH above the median, superficial spreading histology, and female sex were significantly associated with worse OS. We reported grade 3 and 4 treatment-related toxicities in 4 and 0 patients, respectively. In conclusion, chemotherapy with wCP is a valid palliative treatment in advanced melanoma who progressed with anti-PD-1 antibodies.
(© 2024. The Author(s).)
Databáze: MEDLINE
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