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Cancer. 2016 Nov 15;122(21):3344-3353. doi: 10.1002/cncr.30258. Epub 2016 Aug 17.

Clinical outcomes in metastatic uveal melanoma treated with PD-1 and PD-L1 antibodies.

Author information

1
Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California. alain.algazi@ucsf.edu.
2
Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California.
3
Melanoma and Immunotherapeutics Service, Memorial Sloan Kettering Cancer Center, New York, New York.
4
Moffitt Cancer Center, Tampa, Florida.
5
Spanish Melanoma Multidisciplinary Group, Barcelona, Spain.
6
Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
7
Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee.
8
Columbia University Medical Center, New York, New York.
9
Johansson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, California.
10
Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, New York.
11
Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Abstract

BACKGROUND:

Antibodies inhibiting the programmed death receptor 1 (PD-1) have demonstrated significant activity in the treatment of advanced cutaneous melanoma. The efficacy and safety of PD-1 blockade in patients with uveal melanoma has not been well characterized.

METHODS:

Fifty-eight patients with stage IV uveal melanoma received PD-1 or PD-1 ligand (PD-L1) antibodies between 2009 and 2015 at 9 academic centers. Patients who were evaluable for response were eligible for the analysis. Imaging was performed every 12 weeks and at the investigators' discretion. Safety and clinical efficacy outcomes, including the best overall response, progression-free survival (PFS), and overall survival (OS), were retrospectively determined.

RESULTS:

Of 56 eligible patients, 48 (86%) had received prior therapy, and 35 (63%) had received treatment with ipilimumab. Three patients had an objective response to ipilimumab, and 8 had stable disease as their best response. Thirty-eight patients (68%) received pembrolizumab, 16 (29%) received nivolumab, and 2 (4%) received atezolizumab. Objective tumor responses were observed in 2 patients for an overall response rate of 3.6% (95% confidence interval [CI], 1.8%-22.5%). Stable disease (≥6 months) was observed in 5 patients (9%). The median PFS was 2.6 months (95% CI, 2.4-2.8 months), and the median OS was 7.6 months (95% CI, 0.7-14.6 months). There was no association between prior treatment with ipilimumab or liver-directed therapy and PFS or OS. Treatment was well tolerated, and only 1 patient discontinued treatment because of toxicity.

CONCLUSIONS:

PD-1 and PD-L1 antibodies rarely confer durable remissions in patients with metastatic uveal melanoma. Clinical trial enrollment should be prioritized in this population. Cancer 2016;122:3344-3353. © 2016 American Cancer Society.

KEYWORDS:

atezolizumab; immunotherapy; nivolumab; pembrolizumab; uveal melanoma

PMID:
27533448
PMCID:
PMC5767160
DOI:
10.1002/cncr.30258
[Indexed for MEDLINE]
Free PMC Article

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