The oncologist · 2025
Retrospective multicenter analysis of real-life toxicity and outcome of ipilimumab and nivolumab in metastatic uveal melanoma.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ciernik Amélie, Ciernik Laure, Bonczkowitz Peter, Morak Monika, Heinzerling Lucie, Bennaceur Yacine, Lawless Aleigha, Sullivan Ryan, Kött Julian, Gebhardt Christoffer, Carter Thomas J, Nathan Paul, Tschopp Sophie, Dummer Reinhard, Ramelyte Egle
Аннотация
BACKGROUND: Uveal melanoma (UM) is the most common primary ocular malignancy with a high rate of metastases. While immune checkpoint inhibitors (ICIs), including ipilimumab and nivolumab (ipi + nivo), have shown efficacy in metastatic cutaneous melanoma, their success in metastatic UM (MUM) remains limited. This study evaluates toxicity and outcomes of ipi + nivo in the largest, multicenter MUM cohort.
METHODS: We analyzed 131 MUM patients treated with ipi + nivo from 2016 to 2024 across 5 international centers. Rates of toxicity, response, and survival outcomes were assessed.
RESULTS: Among 131 patients, 37.4% of patients received 4 cycles of ipi + nivo. The most common reason for ipi + nivo discontinuation (31.3%) was toxicity. Of all treated patients, 80.2% experienced immune-related adverse events (irAEs). The overall response rate (ORR) was 16.4%, and the disease control rate (DCR) was 43.4%. Progression-free survival (PFS) was three months, and the median overall survival (OS) was 18 months. Patients receiving ipi + nivo as second-line therapy had lower ORR compared to patients who received ipi + nivo as first-line therapy (P = .04). Patients with exclusively extrahepatic metastases had a better ORR and OS compared to those with hepatic or mixed metastases (P = .02, P = .02, respectively). 20.6% of patients developed eosinophilia during treatment, which was associated with improved median OS (24 months vs 15 months, P = .02).
CONCLUSIONS: Ipi + nivo shows moderate efficacy and clinically relevant toxicities in patients with MUM. Eosinophilia is a potential prognostic biomarker, that merits further investigation.
METHODS: We analyzed 131 MUM patients treated with ipi + nivo from 2016 to 2024 across 5 international centers. Rates of toxicity, response, and survival outcomes were assessed.
RESULTS: Among 131 patients, 37.4% of patients received 4 cycles of ipi + nivo. The most common reason for ipi + nivo discontinuation (31.3%) was toxicity. Of all treated patients, 80.2% experienced immune-related adverse events (irAEs). The overall response rate (ORR) was 16.4%, and the disease control rate (DCR) was 43.4%. Progression-free survival (PFS) was three months, and the median overall survival (OS) was 18 months. Patients receiving ipi + nivo as second-line therapy had lower ORR compared to patients who received ipi + nivo as first-line therapy (P = .04). Patients with exclusively extrahepatic metastases had a better ORR and OS compared to those with hepatic or mixed metastases (P = .02, P = .02, respectively). 20.6% of patients developed eosinophilia during treatment, which was associated with improved median OS (24 months vs 15 months, P = .02).
CONCLUSIONS: Ipi + nivo shows moderate efficacy and clinically relevant toxicities in patients with MUM. Eosinophilia is a potential prognostic biomarker, that merits further investigation.