The outcome in patients with BRAF‐mutated metastatic melanoma treated with anti‐programmed death receptor‐1 monotherapy or targeted therapy in the real‐world setting
Abstract Background Immunotherapy and targeted therapy are currently two alternative backbones in the therapy of BRAF‐mutated malignant melanoma. However, predictive biomarkers that would help with treatment selection are lacking. Methods This retrospective study investigated outcomes of anti‐progra...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6982 |
| _version_ | 1797246048503070720 |
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| author | Jindřich Kopecký Marek Pásek Radek Lakomý Bohuslav Melichar Ivona Mrazová Ondřej Kubeček Monika Arenbergerová Radmila Lemstrová Alžběta Švancarová Vojtěch Tretera Alžběta Hlodáková Kamila Žváčková |
| author_facet | Jindřich Kopecký Marek Pásek Radek Lakomý Bohuslav Melichar Ivona Mrazová Ondřej Kubeček Monika Arenbergerová Radmila Lemstrová Alžběta Švancarová Vojtěch Tretera Alžběta Hlodáková Kamila Žváčková |
| author_sort | Jindřich Kopecký |
| collection | DOAJ |
| description | Abstract Background Immunotherapy and targeted therapy are currently two alternative backbones in the therapy of BRAF‐mutated malignant melanoma. However, predictive biomarkers that would help with treatment selection are lacking. Methods This retrospective study investigated outcomes of anti‐programmed death receptor‐1 monotherapy and targeted therapy in the first‐line setting in patients with metastatic BRAF‐mutated melanoma, focusing on clinical and laboratory parameters associated with treatment outcome. Results Data from 174 patients were analysed. The median progression‐free survival (PFS) was 17.0 months (95% CI; 8–39) and 12.5 months (95% CI; 9–14.2) for immunotherapy and targeted therapy, respectively. The 3‐year PFS rate was 39% for immunotherapy and 25% for targeted therapy. The objective response rate was 72% and 51% for targeted therapy and immunotherapy. The median overall (OS) survival for immunotherapy has not been reached and was 23.6 months (95% CI; 16.1–38.2) for targeted therapy, with a 3‐year survival rate of 63% and 40%, respectively. In a univariate analysis, age < 70 years, a higher number of metastatic sites, elevated serum LDH and a neutrophil–lymphocyte ratio above the cut‐off value were associated with inferior PFS regardless of the therapy received, but only serum LDH level and the presence of lung metastases remained significant predictors of PFS in a multivariate analysis. Conclusions Present real‐world data document the high effectiveness of immunotherapy and targeted therapy. Although targeted therapy had higher response rates, immunotherapy improved PFS and OS. While the prognostic value of LDH was confirmed, the potential use of blood cell count‐derived parameters to predict outcomes needs further investigation. |
| first_indexed | 2024-04-24T19:36:36Z |
| format | Article |
| id | doaj.art-97e3502a34ea4d9d90c21a532ba6f4ca |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-24T19:36:36Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-97e3502a34ea4d9d90c21a532ba6f4ca2024-03-25T13:10:38ZengWileyCancer Medicine2045-76342024-03-01135n/an/a10.1002/cam4.6982The outcome in patients with BRAF‐mutated metastatic melanoma treated with anti‐programmed death receptor‐1 monotherapy or targeted therapy in the real‐world settingJindřich Kopecký0Marek Pásek1Radek Lakomý2Bohuslav Melichar3Ivona Mrazová4Ondřej Kubeček5Monika Arenbergerová6Radmila Lemstrová7Alžběta Švancarová8Vojtěch Tretera9Alžběta Hlodáková10Kamila Žváčková11Department of Clinical Radiotherapy and Oncology University Hospital in Hradec Kralove Hradec Kralove Czech RepublicDepartment of Dermatovenereology, Third Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital Prague Czech RepublicDepartment of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of Medicine Masaryk University Brno Czech RepublicDepartment of Oncology, Faculty of Medicine and Dentistry Palacký University and University Hospital Olomouc Czech RepublicDepartment of Oncology County Hospital České Budějovice Czech RepublicDepartment of Clinical Radiotherapy and Oncology University Hospital in Hradec Kralove Hradec Kralove Czech RepublicDepartment of Dermatovenereology, Third Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital Prague Czech RepublicDepartment of Oncology, Faculty of Medicine and Dentistry Palacký University and University Hospital Olomouc Czech RepublicDepartment of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of Medicine Masaryk University Brno Czech RepublicDepartment of Dermatovenereology, Third Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital Prague Czech RepublicDepartment of Clinical Radiotherapy and Oncology University Hospital in Hradec Kralove Hradec Kralove Czech RepublicDepartment of Oncology, Faculty of Medicine and Dentistry Palacký University and University Hospital Olomouc Czech RepublicAbstract Background Immunotherapy and targeted therapy are currently two alternative backbones in the therapy of BRAF‐mutated malignant melanoma. However, predictive biomarkers that would help with treatment selection are lacking. Methods This retrospective study investigated outcomes of anti‐programmed death receptor‐1 monotherapy and targeted therapy in the first‐line setting in patients with metastatic BRAF‐mutated melanoma, focusing on clinical and laboratory parameters associated with treatment outcome. Results Data from 174 patients were analysed. The median progression‐free survival (PFS) was 17.0 months (95% CI; 8–39) and 12.5 months (95% CI; 9–14.2) for immunotherapy and targeted therapy, respectively. The 3‐year PFS rate was 39% for immunotherapy and 25% for targeted therapy. The objective response rate was 72% and 51% for targeted therapy and immunotherapy. The median overall (OS) survival for immunotherapy has not been reached and was 23.6 months (95% CI; 16.1–38.2) for targeted therapy, with a 3‐year survival rate of 63% and 40%, respectively. In a univariate analysis, age < 70 years, a higher number of metastatic sites, elevated serum LDH and a neutrophil–lymphocyte ratio above the cut‐off value were associated with inferior PFS regardless of the therapy received, but only serum LDH level and the presence of lung metastases remained significant predictors of PFS in a multivariate analysis. Conclusions Present real‐world data document the high effectiveness of immunotherapy and targeted therapy. Although targeted therapy had higher response rates, immunotherapy improved PFS and OS. While the prognostic value of LDH was confirmed, the potential use of blood cell count‐derived parameters to predict outcomes needs further investigation.https://doi.org/10.1002/cam4.6982BRAF mutationimmunotherapyreal‐world datatargeted therapy |
| spellingShingle | Jindřich Kopecký Marek Pásek Radek Lakomý Bohuslav Melichar Ivona Mrazová Ondřej Kubeček Monika Arenbergerová Radmila Lemstrová Alžběta Švancarová Vojtěch Tretera Alžběta Hlodáková Kamila Žváčková The outcome in patients with BRAF‐mutated metastatic melanoma treated with anti‐programmed death receptor‐1 monotherapy or targeted therapy in the real‐world setting Cancer Medicine BRAF mutation immunotherapy real‐world data targeted therapy |
| title | The outcome in patients with BRAF‐mutated metastatic melanoma treated with anti‐programmed death receptor‐1 monotherapy or targeted therapy in the real‐world setting |
| title_full | The outcome in patients with BRAF‐mutated metastatic melanoma treated with anti‐programmed death receptor‐1 monotherapy or targeted therapy in the real‐world setting |
| title_fullStr | The outcome in patients with BRAF‐mutated metastatic melanoma treated with anti‐programmed death receptor‐1 monotherapy or targeted therapy in the real‐world setting |
| title_full_unstemmed | The outcome in patients with BRAF‐mutated metastatic melanoma treated with anti‐programmed death receptor‐1 monotherapy or targeted therapy in the real‐world setting |
| title_short | The outcome in patients with BRAF‐mutated metastatic melanoma treated with anti‐programmed death receptor‐1 monotherapy or targeted therapy in the real‐world setting |
| title_sort | outcome in patients with braf mutated metastatic melanoma treated with anti programmed death receptor 1 monotherapy or targeted therapy in the real world setting |
| topic | BRAF mutation immunotherapy real‐world data targeted therapy |
| url | https://doi.org/10.1002/cam4.6982 |
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