Efficacy of late concurrent hypofractionated radiotherapy in advanced melanoma patients failing anti‐PD‐1 monotherapy
| Autor: | Astrid Blom, Blandine Boru, Iman Aouidad, Yves Otmezguine, Bouchra Baghad, Magali Fort, P. Saiag, Elisa Funck-Brentano, A. Beauchet, C. Longvert, Anissa Roger |
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| Přispěvatelé: | Biomarqueurs et essais cliniques en Cancérologie et Onco-Hématologie (BECCOH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Américain de Paris, Hôpital Ambroise Paré [AP-HP], The authors would like to thank the patients presented in our study. |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male anti-PD-1 antibody Cancer Research medicine.medical_specialty Skin Neoplasms abscopal effect medicine.medical_treatment Programmed Cell Death 1 Receptor [SDV.CAN]Life Sciences [q-bio]/Cancer Pembrolizumab Radiosurgery 03 medical and health sciences 0302 clinical medicine melanoma medicine Clinical endpoint Humans Prospective Studies Adverse effect Immune Checkpoint Inhibitors Response Evaluation Criteria in Solid Tumors radiotherapy Aged Retrospective Studies Aged 80 and over nivolumab business.industry Abscopal effect Chemoradiotherapy Middle Aged Evaluable Disease Progression-Free Survival 3. Good health Radiation therapy Regimen Oncology 030220 oncology & carcinogenesis Disease Progression Female Radiation Dose Hypofractionation pembrolizumab Radiology business |
| Zdroj: | International Journal of Cancer International Journal of Cancer, Wiley, 2020, 147 (6), pp.1707-1714. ⟨10.1002/ijc.32934⟩ |
| ISSN: | 1097-0215 0020-7136 |
| Popis: | International audience; Advanced melanoma patients who failed anti-PD-1 therapy have limited options. We analyzed a cohort of 133 advanced melanoma patients receiving anti-PD-1 monotherapy in a referral center between April 2015 and December 2017, and included the 26 patients with confirmed progressive (PD) or stable disease who received additional radiotherapy with an unmodified anti-PD-1 mAb regimen. Tumor evaluations were done on radiated and nonradiated (RECIST 1.1) lesions, with abscopal effect defined as a partial (PR) or complete response (CR) outside radiated fields. Primary endpoint was the CR + PR rate in radiated + nonradiated lesions. Secondary endpoints were progression-free survival (PFS), melanoma-specific survival (MSS) and safety. First late radiotherapy, consisting of hypofractionated radiotherapy (3–5 sessions, 20–26 Gy), standard palliative radiotherapy or brain radiosurgery was begun after a median of 6.3 months of anti-PD-1 in 23, 2 and 1 patient(s), respectively. Best response was 8 (31%) CR, 2 (8%) profound PR allowing surgical resection of remaining metastases and 16 (62%) PD. Abscopal effect was seen in 35% of patients. Median PFS and MSS since anti-PD-1 initiation was 15.2 [95% CI: 8.0 not achieved (na)] and 35.3 [95% CI: 18.5 na] months, respectively. PFS curves seemed to achieve a plateau. We discontinued anti-PD-1 therapy in 9/10 of patients with no residual evaluable disease and observed one relapse after a median of 10 months off anti-PD1-therapy. No unusual adverse event was recorded. Limitations of the study include its retrospective nature and limited size. Hypofractionated radiotherapy may enhance anti-PD1 monotherapy efficacy in patients who previously failed anti-PD-1 therapy. Controlled studies are needed. |
| Databáze: | OpenAIRE |
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