Outcomes following long-term disease control with immune checkpoint inhibitors in patients with advanced melanoma
- PMID: 39667250
- DOI: 10.1016/j.ejca.2024.115171
Outcomes following long-term disease control with immune checkpoint inhibitors in patients with advanced melanoma
Abstract
Immune checkpoint inhibitors (ICI) can achieve durable responses in patients with advanced melanoma, and results from clinical trials suggest cure may be possible for a subset of patients. Despite clinical trial data, little is known about the risk, character, and clinical outcome of late recurrences after ICI. This study aimed to explore the disease outcomes and survival in a cohort of patients with long-term responses to ICI. We retrospectively identified patients treated with ICI for advanced melanoma with long-term disease control, defined as not requiring a subsequent line of systemic therapy within 3 years of ICI commencement. We analysed disease characteristics, treatment, toxicity, recurrence patterns, management, and outcomes. A total of 567 patients were identified with a median follow-up of 7.1 years: 504 (89 %) without disease progression within 3 years (cohort 1) and 63 (11.1 %) with disease progression within 3 years managed without a change in systemic therapy (cohort 2). Subsequent progression after 3 years occurred for 39 (7.7 %) patients in cohort 1, compared to 14 (22 %) in cohort 2. Predictors for late progression after 3 years were a non-complete radiological response (CR) best response and prior progression within 3 years. Thirty-two patients (5.6 %) died during follow-up, 8 (1.4 %) from melanoma, 6 (1.2 %) from cohort 1 and 2 (3.2 %) from cohort 2. In this population of patients with advanced melanoma with long-term disease control from ICI, the risk of subsequent disease progression and death was low. This suggests that a significant proportion of long-term ICI responders are likely cured and may inform the frequency and duration of follow-up.
Keywords: Checkpoint inhibitors; Immunotherapy; Melanoma; Survival.
Copyright © 2024 Elsevier Ltd. All rights reserved.
Conflict of interest statement
Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: RJS reports having served on advisory boards/performed consulting for BMS, Merck, Marengo, Pfizer, Novartis, and Replimune and received research funding from Merck. DBJ reports having served on advisory boards or as a consultant for AstraZeneca, BMS, Jackson Laboratories, Merck, Novartis, Pfizer, and Teiko. MSC reports having served on advisory boards or as a consultant for Amgen, BMS, Eisai, Ideaya, MSD, Nektar, Novartis, Oncosec, Pierre-Fabre, Qbiotics, Regeneron, Roche, Merck, Strand Pharmaceuticals, Onchilles and Sanofi, and received honoraria from BMS, MSD, and Novartis. GVL is consultant advisor for Agenus, Amgen, Array Biopharma, AstraZeneca, Bayer, BioNTech, Boehringer Ingelheim, Bristol Myers Squibb, Evaxion, GI Innovation, Hexal AG (Sandoz Company), Highlight Therapeutics S.L., IOBiotech, Immunocore, Innovent Biologics USA, MSD, Novartis, PHMR Ltd, Pierre Fabre, Regeneron, Scancell, SkylineDX B.V. SNL has received fees for professional services from SkylineDx and a stipend for editorial services at the British Journal of Dermatology. AMM has served on advisory boards for BMS, MSD, Novartis, Roche, Pierre-Fabre, QBiotics. PR has received honoraria for lectures and Advisory Boards from MSD, BMS, Novartis, Pierre Fabre, Merck, Genesis Pharma, Medison Pharma outside of the scope of this study. AMC reports having served as a speaker for Pierre Fabre, MSD, BMS and Novartis. PAA has/had a consultant/advisory role for Bristol Myers Squibb, Roche-Genentech, Merck Sharp & Dohme, Novartis, Pierre-Fabre, Sun Pharma, Sanofi, Sandoz, Immunocore, Italfarmaco, Boehringer-Ingelheim, Regeneron, Pfizer, Nouscom, Medicenna, Bio-Al Health, ValoTX, Replimmune, Bayer, Erasca, Philogen, Biontech, Anaveon, Genmab, Menarini. He also received research funding from Bristol Myers Squibb, Roche-Genentech, Pfizer, Sanofi. Travel support by Pfizer, Bio-Al Health, Replimmune, MSD, Pierre Fabre, Philogen. BN reports having served on advisory boards or as a consultant for Roche, Bristol-Myers Squibb, Merck Sharp & Dohme, and Novartis and his institution (UZ Brussel) received research funding outside the scope of this study. CL reports having served on advisory boards or as a consultant or speaker for BMS, Pierre Fabre, Sanofil, Novartis, MSD, Amgen, Merck Senoro, Roche, Inflax, Pfizer, Incyte and has received research funding from BMS and Roche outside the scope of this study. CA reports having served as a speaker for Novartis. LZ served as consultant and has received honoraria from BMS, MSD, Novartis, Pierre Fabre, Sanofi, and Sunpharma and travel support from MSD, BMS, Pierre Fabre, Sanofi, Sunpharma and Novartis, outside the submitted work. MO has served as a speaker for BMS, Novartis and MDS. LJA received honoraria from Novartis, Sunpharma and Bristol-Myers Squibb and travel support from Sunpharma, Takeda and Sanofi, outside the submitted work. JIK has received honoraria from AMGEN, BMS, Janssen. Travel support by LEO pharma, UCB and Janssen. Research funds from LEO pharma. RD has intermittent, project focused consulting and/or advisory relationships with Novartis, Merck Sharp & Dhome (MSD), Bristol-Myers Squibb (BMS), Roche, Amgen, Takeda, Pierre Fabre, Sun Pharma, Sanofi, Catalym, Second Genome, Regeneron, T3 Pharma, MaxiVAX SA, Pfizer and Simcere outside the submitted work. JM has intermittent project focused consultant or advisory relationships with Merck Sharp & Dohme, Novartis, Johnson & Johnson, Bristol Myers Squibb and Pierre Fabre and has received travel support from L′ oreal, Merck Sharp & Dohme, Bristol Myers and Squibb und Pierre Fabre outside of the submitted work. All remaining authors have declared no conflicts of interest.
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