The Management of Oligoprogression in the Landscape of New Therapies for Metastatic Melanoma

Autor: Federica De Luca, Francesco Figliuolo, Sabino Strippoli, Fabio Mele, Annalisa Nardone, Ruggero Filannino, Stefania Tommasi, Eustachio Ruggieri, Michele Traversa, Nicola Bartolomeo, Andrea Armenio, Ivana De Risi, Livia Fucci, Francesco Macina, Michele Guida
Rok vydání: 2019
Předmět:
Zdroj: Cancers
Cancers, Vol 11, Iss 10, p 1559 (2019)
ISSN: 2072-6694
Popis: Background: A limited degree of progression after a response to treatment is labelled as oligoprogression and is a hot topic of metastatic melanoma (MM) management. Rogue progressive metastases could benefit from local treatment, which could allow the continuation of ongoing systemic therapy, also known as treatment beyond progression (TBP). Methods: We retrospectively reviewed 214 selected MM patients who were treated with v-Raf murine sarcoma viral oncogene homolog B (BRAF)/mitogen-activated-extracellular signal-regulated kinase (MEK) or programmed cell death protein 1 (PD-1) inhibitors and received a local treatment continuing TBP. We performed univariate and multivariable analyses to assess the association between therapy outcomes and a series of clinical and biological features. Results: We identified 27 (10%) oligoprogressed patients treated locally with surgery (14), radiosurgery (11), and electrochemotherapy (2). TBP included PD-1 inhibitors (13) and BRAF/MEK inhibitors (14). The median progression-free survival post oligoprogression (PFSPO) was 14 months (5–19 95% confidence interval (C.I.)). In the univariate analysis, a significantly longer PFSPO was associated with complete response (CR), Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, neutrophils/lymphocytes ratio (N/L) 11 months. Nevertheless, in the multivariable analysis, only CR and N/L Conclusions: In selected patients, local treatments contribute to controlling oligoprogression for a long time, allowing the continuation of systemic treatment and prolongation of overall survival (OS). Increasing biological and clinical knowledge is improving the accuracy in identifying patients to apply for local ablative therapies.
Databáze: OpenAIRE
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