Real-World Impact of Immune Checkpoint Inhibitors in Metastatic Uveal Melanoma
Uveal melanoma (UM) is the most common intraocular malignancy in adults and shows a high rate of metastatic spread. As randomized clinical trials with immune checkpoint inhibitors (ICI) have not been performed in patients with metastatic UM, we analyzed the real-world outcomes in a nationwide popula...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/11/10/1489 |
| _version_ | 1797725662389207040 |
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| author | Kalijn Fredrike Bol Eva Ellebaek Lise Hoejberg Mette Marie Bagger Mathilde Skaarup Larsen Tobias Wirenfeldt Klausen Ulrich Heide Køhler Henrik Schmidt Lars Bastholt Jens Folke Kiilgaard Marco Donia Inge Marie Svane |
| author_facet | Kalijn Fredrike Bol Eva Ellebaek Lise Hoejberg Mette Marie Bagger Mathilde Skaarup Larsen Tobias Wirenfeldt Klausen Ulrich Heide Køhler Henrik Schmidt Lars Bastholt Jens Folke Kiilgaard Marco Donia Inge Marie Svane |
| author_sort | Kalijn Fredrike Bol |
| collection | DOAJ |
| description | Uveal melanoma (UM) is the most common intraocular malignancy in adults and shows a high rate of metastatic spread. As randomized clinical trials with immune checkpoint inhibitors (ICI) have not been performed in patients with metastatic UM, we analyzed the real-world outcomes in a nationwide population-based study. Clinical data of patients with UM were extracted from the Danish Metastatic Melanoma database, a nationwide database containing unselected records of patients diagnosed with metastatic melanoma in Denmark. Survival before (pre-ICI, <i>n</i> = 32) and after (post-ICI, <i>n</i> = 94) the approval of first-line treatment with ICI was analyzed. A partial response to first-line treatment was observed in 7% of patients treated with anti-programmed cell death protein (PD)-1 monotherapy and in 21% with combined anti-cytotoxic T lymphocyte antigen (CTLA)-4 plus anti-PD-1 therapy. Median progression-free survival was 2.5 months for patients treated in the pre-ICI era compared to 3.5 months in the post-ICI era (hazard ratio (HR) 0.43; 95% confidence interval (CI) 0.28−0.67; <i>p</i> < 0.001). The estimated one-year overall survival rate increased from 25.0% to 41.9% and the median overall survival improved from 7.8 months to 10.0 months, respectively (HR 0.52; 95% CI 0.34−0.79; <i>p</i> = 0.003). Thus, the introduction of ICI as first-line treatment appears to have significantly improved the real-world survival of patients with metastatic UM, despite relatively low response rates compared to cutaneous melanoma. With the lack of therapies proven effective in randomized trials, these data support the current treatment with ICI in patients with metastatic UM. |
| first_indexed | 2024-03-12T10:34:30Z |
| format | Article |
| id | doaj.art-493d6a4b6e524416b2e978615b060da4 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T10:34:30Z |
| publishDate | 2019-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-493d6a4b6e524416b2e978615b060da42023-09-02T08:57:23ZengMDPI AGCancers2072-66942019-10-011110148910.3390/cancers11101489cancers11101489Real-World Impact of Immune Checkpoint Inhibitors in Metastatic Uveal MelanomaKalijn Fredrike Bol0Eva Ellebaek1Lise Hoejberg2Mette Marie Bagger3Mathilde Skaarup Larsen4Tobias Wirenfeldt Klausen5Ulrich Heide Køhler6Henrik Schmidt7Lars Bastholt8Jens Folke Kiilgaard9Marco Donia10Inge Marie Svane11Department of Oncology, National Center for Cancer Immune Therapy, Herlev Hospital, Copenhagen University Hospital, 2730 Herlev, DenmarkDepartment of Oncology, National Center for Cancer Immune Therapy, Herlev Hospital, Copenhagen University Hospital, 2730 Herlev, DenmarkDepartment of Oncology, Odense University Hospital, 5000 Odense, DenmarkDepartment of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, DenmarkDepartment of Pathology, Herlev Hospital, Copenhagen University Hospital, 2730 Herlev, DenmarkDepartment of Oncology, National Center for Cancer Immune Therapy, Herlev Hospital, Copenhagen University Hospital, 2730 Herlev, DenmarkDepartment of Oncology, Odense University Hospital, 5000 Odense, DenmarkDepartment of Oncology, Aarhus University Hospital, 8200 Aarhus, DenmarkDepartment of Oncology, Odense University Hospital, 5000 Odense, DenmarkDepartment of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, DenmarkDepartment of Oncology, National Center for Cancer Immune Therapy, Herlev Hospital, Copenhagen University Hospital, 2730 Herlev, DenmarkDepartment of Oncology, National Center for Cancer Immune Therapy, Herlev Hospital, Copenhagen University Hospital, 2730 Herlev, DenmarkUveal melanoma (UM) is the most common intraocular malignancy in adults and shows a high rate of metastatic spread. As randomized clinical trials with immune checkpoint inhibitors (ICI) have not been performed in patients with metastatic UM, we analyzed the real-world outcomes in a nationwide population-based study. Clinical data of patients with UM were extracted from the Danish Metastatic Melanoma database, a nationwide database containing unselected records of patients diagnosed with metastatic melanoma in Denmark. Survival before (pre-ICI, <i>n</i> = 32) and after (post-ICI, <i>n</i> = 94) the approval of first-line treatment with ICI was analyzed. A partial response to first-line treatment was observed in 7% of patients treated with anti-programmed cell death protein (PD)-1 monotherapy and in 21% with combined anti-cytotoxic T lymphocyte antigen (CTLA)-4 plus anti-PD-1 therapy. Median progression-free survival was 2.5 months for patients treated in the pre-ICI era compared to 3.5 months in the post-ICI era (hazard ratio (HR) 0.43; 95% confidence interval (CI) 0.28−0.67; <i>p</i> < 0.001). The estimated one-year overall survival rate increased from 25.0% to 41.9% and the median overall survival improved from 7.8 months to 10.0 months, respectively (HR 0.52; 95% CI 0.34−0.79; <i>p</i> = 0.003). Thus, the introduction of ICI as first-line treatment appears to have significantly improved the real-world survival of patients with metastatic UM, despite relatively low response rates compared to cutaneous melanoma. With the lack of therapies proven effective in randomized trials, these data support the current treatment with ICI in patients with metastatic UM.https://www.mdpi.com/2072-6694/11/10/1489uveal melanomaimmunotherapyimmune checkpoint inhibitorsreal-world data |
| spellingShingle | Kalijn Fredrike Bol Eva Ellebaek Lise Hoejberg Mette Marie Bagger Mathilde Skaarup Larsen Tobias Wirenfeldt Klausen Ulrich Heide Køhler Henrik Schmidt Lars Bastholt Jens Folke Kiilgaard Marco Donia Inge Marie Svane Real-World Impact of Immune Checkpoint Inhibitors in Metastatic Uveal Melanoma Cancers uveal melanoma immunotherapy immune checkpoint inhibitors real-world data |
| title | Real-World Impact of Immune Checkpoint Inhibitors in Metastatic Uveal Melanoma |
| title_full | Real-World Impact of Immune Checkpoint Inhibitors in Metastatic Uveal Melanoma |
| title_fullStr | Real-World Impact of Immune Checkpoint Inhibitors in Metastatic Uveal Melanoma |
| title_full_unstemmed | Real-World Impact of Immune Checkpoint Inhibitors in Metastatic Uveal Melanoma |
| title_short | Real-World Impact of Immune Checkpoint Inhibitors in Metastatic Uveal Melanoma |
| title_sort | real world impact of immune checkpoint inhibitors in metastatic uveal melanoma |
| topic | uveal melanoma immunotherapy immune checkpoint inhibitors real-world data |
| url | https://www.mdpi.com/2072-6694/11/10/1489 |
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