Discontinuation of combo immunotherapy and outcome of patients with melanoma brain metastases.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mandalà Mario, Chen Monica F, Sullivan Ryan J, Sergi Maria Chiara, Postow Michael, Lawless Aleigha R, Effiom Derek, Peres Tobias, Lorigan Paul C, Serra-Bellver Patricio, Dummer Reinhard, Amaral Teresa, Rasch Marie-Lena, Giannarelli Diana, Vitale Maria Grazia, Helgadottir Hildur, Robert Caroline, Ubaldi Martina, Johnson Douglas B, Del Vecchio Michele, Indini Alice, Suijkerbuijk Karijn P M, Nathan Paul, Carter Thomas, Neyns Bart, Dirven Iris, Pires da Silva Ines, Menzies Alexander Maxwell, Zimmer Lisa, Livingstone Elisabeth, Depenni Roberta, Kähler Katharina, Hauschild Axel, Spagnolo Francesco, Di Giacomo Anna Maria, Arance Ana, Merelli Barbara, Quaglino Pietro, Rossi Ernesto, Tucci Marco, Guida Michele, Muñoz-Couselo Eva, Long Georgina V, Larkin James, Ascierto Paolo A
Аннотация
METHODS: Patients with MBM treated with COMBO who discontinued treatment within 24 months for reasons other than disease progression or continued beyond this time point were retrieved. Overall survival (OS), objective response, progression-free survival (PFS) and toxicities were analyzed.
RESULTS: 465 patients were included: 392 discontinued COMBO within 24 months, while 73 continued beyond 24 months. Treatment was discontinued due to complete response (CR, n=47), partial response (PR, n=45), stable disease (SD, n=12), toxicity after SD (n=59), toxicity after CR (n=99), or toxicity after PR (n=130). At multivariable analysis, the line of treatment (>first vs first: HR 2.65 (1.62-4.32)), the immune-related adverse events (irrespective of anti-tumor necrosis factor-alpha) (HR 0.18 (0.07-0.42)); COMBO discontinuation after CR (HR 0.15 (0.05-0.40)), or PR (HR 0.08 (0.03-0.26)), as well as stopping due to toxicity after CR (HR 0.14 (0.07-0.27)) or PR (HR 0.51 (0.32-0.82)), were associated with OS. Notably, at a median follow-up of 51 months (IQR 31-70), patients with CR/PR who discontinued COMBO within 24 months had PFS and OS comparable to those who continued treatment beyond this time point. 4-year OS exceeded 83% in patients discontinuing COMBO after CR, PR, or toxicity following CR, compared with 66.4% in those discontinuing due to toxicity after PR; median PFS was not reached in the former groups but was 18.6 months in the toxicity after PR group.
CONCLUSION: Discontinuation of COMBO within 24 months appears safe in patients with CR and in selected cases of PR, with no survival disadvantage versus prolonged therapy.