Alexander Maurer, Giulio Clerici, Jan A Schaab, Phil F Cheng, Daniela Mihic-Probst, Cäcilia Mader, Michael Messerli, Martin W Huellner, Reinhard Dummer, Florentia Dimitriou
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Progression-free survival (PFS) and OS rates, liver-specific response and pathological assessment in available liver biopsies were evaluated. In the ipilimumab/nivolumab group, median PFS (mPFS) was 2.9 months (95% CI 2.2-28.6) and mOS 28.9 months (95% CI 12.7-NR). Complete (CMR) and partial (PMR) metabolic response per imPERCIST5, and partial response (PR) per RECISTv1.1 were associated with longer PFS and OS by trend, compared to morphologically and metabolically stable or progressive disease. In the tebentafusp group, mPFS was 2.7 months (95% CI 2.2-3) and mOS 18.6 months (95% CI 11.5-NR). PMR and PR were associated with longer PFS by trend. In both treatments, the overall treatment response was associated with the radiological response at the liver site. In available liver tumor biopsies, differences in pathological and radiological responses were noted. ImPERCIST5 and RECIST v1.1 are valuable tools in the radiological response assessment, but both methods display limitations. 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引用次数: 0
摘要
转移性葡萄膜黑色素瘤(mUM)预后不良。Ipilimumab/nivolumab在II期研究中显示出抗肿瘤疗效。在一项III期研究中,与研究者的选择相比,Tebentafusp的总生存期(OS)更长。我们试图描述接受免疫疗法治疗的mUM患者的放射学反应模式。我们回顾性地确定并纳入了2018年7月至2022年12月期间接受ipilimumab/nivolumab和tebentafusp治疗的mUM患者,这些患者均可根据RECISTv1.1和/或imPERCIST5进行放射学评估。评估了无进展生存期(PFS)和OS率、肝脏特异性反应和可用肝脏活检的病理评估。在伊匹单抗/尼伐单抗组中,中位无进展生存期(mPFS)为2.9个月(95% CI 2.2-28.6),mOS为28.9个月(95% CI 12.7-NR)。根据imPERCIST5标准,完全(CMR)和部分(PMR)代谢反应以及根据RECISTv1.1标准,部分反应(PR)与形态和代谢稳定或进展性疾病相比,与更长的PFS和OS趋势相关。在特本芴素组,mPFS 为 2.7 个月(95% CI 2.2-3),mOS 为 18.6 个月(95% CI 11.5-NR)。从趋势上看,PMR 和 PR 与较长的 PFS 相关。在两种疗法中,总体治疗反应与肝脏部位的放射学反应相关。在现有的肝脏肿瘤活检中,病理学和放射学反应存在差异。ImPERCIST5 和 RECIST v1.1 是放射学反应评估的重要工具,但这两种方法都有局限性。我们需要准确的生物标志物来对有疾病进展风险的患者进行分层,并在未来开展转化研究来探究反应和耐药性的机制。
Immunotherapy response and resistance in patients with advanced uveal melanoma: a retrospective cohort study.
Metastatic uveal melanoma (mUM) is associated with poor prognosis. Ipilimumab/nivolumab has shown antitumor efficacy in phase II studies. Tebentafusp resulted in longer overall survival (OS) compared to investigator`s choice in a phase III study. We sought to describe the radiological response patterns of mUM patients treated with immunotherapy. Patients with mUM treated with ipilimumab/nivolumab and tebentafusp between July 2018 and December 2022, with available radiological assessment per RECISTv1.1 and/or imPERCIST5, were retrospectively identified and included. Progression-free survival (PFS) and OS rates, liver-specific response and pathological assessment in available liver biopsies were evaluated. In the ipilimumab/nivolumab group, median PFS (mPFS) was 2.9 months (95% CI 2.2-28.6) and mOS 28.9 months (95% CI 12.7-NR). Complete (CMR) and partial (PMR) metabolic response per imPERCIST5, and partial response (PR) per RECISTv1.1 were associated with longer PFS and OS by trend, compared to morphologically and metabolically stable or progressive disease. In the tebentafusp group, mPFS was 2.7 months (95% CI 2.2-3) and mOS 18.6 months (95% CI 11.5-NR). PMR and PR were associated with longer PFS by trend. In both treatments, the overall treatment response was associated with the radiological response at the liver site. In available liver tumor biopsies, differences in pathological and radiological responses were noted. ImPERCIST5 and RECIST v1.1 are valuable tools in the radiological response assessment, but both methods display limitations. Accurate biomarkers to stratify patients at risk for disease progression and future translational studies to investigate mechanisms of response and resistance are required.
期刊介绍:
Clinical and Experimental Medicine (CEM) is a multidisciplinary journal that aims to be a forum of scientific excellence and information exchange in relation to the basic and clinical features of the following fields: hematology, onco-hematology, oncology, virology, immunology, and rheumatology. The journal publishes reviews and editorials, experimental and preclinical studies, translational research, prospectively designed clinical trials, and epidemiological studies. Papers containing new clinical or experimental data that are likely to contribute to changes in clinical practice or the way in which a disease is thought about will be given priority due to their immediate importance. Case reports will be accepted on an exceptional basis only, and their submission is discouraged. The major criteria for publication are clarity, scientific soundness, and advances in knowledge. In compliance with the overwhelmingly prevailing request by the international scientific community, and with respect for eco-compatibility issues, CEM is now published exclusively online.