Sustainable responses in metastatic melanoma patients with and without brain metastases after elective discontinuation of anti-PD1-based immunotherapy due to complete response
Dimitriou F, Zaremba A, Allayous C, Kähler KC, Gerard CL, Festino L, Schäfer S, Toussaint F, Heinzerling L, Hassel JC, Ascierto PA, Michielin O, Hauschild A, Lebbe C, Livingstone E, Ramelyte E, Cheng PF, Dummer R, Mangana J (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 149
Pages Range: 37-48
DOI: 10.1016/j.ejca.2021.02.037
Abstract
Background: Anti-PD1–based immunotherapy is currently used in most patients with advanced melanoma. Despite the remarkable data regarding overall survival, the optimal treatment duration is still unknown. Methods: We evaluated the outcome of 125 patients with advanced melanoma with and without brain metastases (MBM), treated either with anti-PD1 monotherapy (N = 97) or combined with anti-CTLA4 (N = 28) after elective treatment discontinuation due to complete response (CR) (group A, N = 86), or treatment-limiting toxicity (N = 33) and investigator's decision (ID, N = 6) (group B) with subsequent CR. Results: For group A, median duration of treatment (mDoT) was 22 months (range 5–49) and median time to CR 9 months (range 2–47). Accordingly, mDoT for group B was 3 months (range 0–36) and median time to CR 7 months (range 1–32). Seven patients from group A and three from group B experienced disease recurrence. Off-treatment survival was not reached. Median off-treatment response time (mOTRt) was 19 months (range 0–42) and 25 months (range 0–66), respectively. For MBM, mOTRt was 17 months (range 7–41) and 28 months (range 9–39), respectively. After a median follow-up of 38 months (range 9–70), seven (5.6%) patients had deceased, one (0.8%) due to melanoma. Conclusions: Treatment discontinuation is feasible also in patients with MBM. Efficacy outcomes seemed to be similar in both groups of patients who achieved CR, regardless of reason for discontinuation. In patients who experienced disease relapse, treatment re-challenge with anti-PD1 resulted in subsequent renewed response.
Authors with CRIS profile
Involved external institutions
Universitätsspital Zürich (USZ)
Switzerland (CH)
Universitätsklinikum Essen
Germany (DE)
Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal
France (FR)
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV)
Switzerland (CH)
Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"
Italy (IT)
Universitätsklinikum Heidelberg
Germany (DE)
Switzerland (CH)
Universitätsklinikum Essen
Germany (DE)
Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal
France (FR)
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV)
Switzerland (CH)
Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"
Italy (IT)
Universitätsklinikum Heidelberg
Germany (DE)
How to cite
APA:
Dimitriou, F., Zaremba, A., Allayous, C., Kähler, K.C., Gerard, C.L., Festino, L.,... Mangana, J. (2021). Sustainable responses in metastatic melanoma patients with and without brain metastases after elective discontinuation of anti-PD1-based immunotherapy due to complete response. European Journal of Cancer, 149, 37-48. https://doi.org/10.1016/j.ejca.2021.02.037
MLA:
Dimitriou, Florentia, et al. "Sustainable responses in metastatic melanoma patients with and without brain metastases after elective discontinuation of anti-PD1-based immunotherapy due to complete response." European Journal of Cancer 149 (2021): 37-48.
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