Exploratory analysis of clinical benefit of ipilimumab and nivolumab treatment in patients with metastatic melanoma from a single institution

• C. M. Vila ^[1] ; F. A. Moreno ^[1] ; M. M. Estébanez ^[2] ; G. R. Ares ^[1] ; G. Villacampa ^[3] ; P. Dashti ^[1] ; H. S. Oberoi ^[1] ; R. Martin Huertas ^[1] ; P. Jares ^[4] ; L. Alos ^[5] ; C. Teixido ^[5] ; R. Rull ^[6] ; M. Sanchez ^[7] ; J. Malvehy ^[8] ; E. Carcelero ^[9] ; I. Valduvieco ^[10] ; A. A. Fernandez ^[5]
  1. [1] Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
  2. [2] Department of Oncology, Galdakao Hospital, Galdakao, Galdakao, Spain
  3. [3] Oncology Data Science, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
  4. [4] Department of Pathology, Hospital Clinic, Barcelona, Spain
  5. [5] Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
  6. [6] Department of General Surgery, Hospital Clinic, Barcelona, Spain
  7. [7] Department of Radiology, Hospital Clinic, Barcelona, Spain
  8. [8] Department of Dermatology, Hospital Clinic, Barcelona, Spain
  9. [9] Department of Pharmacy, Hospital Clinic, Barcelona, Spain
  10. [10] Department of Radiotherapy, Hospital Clinic, Barcelona, Spain

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 24, Nº. 2, 2022, págs. 319-330
• Idioma: inglés
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• Resumen

  • Purpose We retrospectively analysed overall survival (OS) and potential predictive biomarkers of OS in patients with meta- static melanoma treated with ipilimumab plus nivolumab in a single institution.

    Methods and patients Electronic medical records of patients with advanced melanoma receiving ≥ 1 dose of a combined ipilimumab plus nivolumab regimen between March 3, 2016 and March 7, 2020 in a single institution, were reviewed. OS was analysed using the Kaplan–Meier method. Sub-group analyses were conducted to examine several endpoints according to relevant clinical, molecular and pathological variables using logistic and Cox models.

    Results Forty-four cases were reviewed, 38 (86.4%), of whom had cutaneous melanoma, 21 (47.7%) were BRAF mutant, 21 (47.7%) presented high lactate dehydrogenase (LDH) values, 23 (52.3%) had ≥ 3 disease sites, and 10 (22.7%) patients had brain metastases. The median follow-up was 37.7 months, and the median OS was 21.1 months (95% CI 8.2–NR). In the multivariate analysis, the OS was significantly longer in patients with an Eastern Cooperative Oncology Group (ECOG) score of 0, LDH ≤ upper limit of normal, absence of liver metastases and neutrophil-to-lymphocyte ratio (NLR) < 5 (all p ≤ 0.05, log-rank test). These factors allowed the classification of patients into three prognostic risk groups (low/intermedi- ate/high risk) for death.

    Conclusion Overall survival of real-world patients from our cohort receiving ipilimumab plus nivolumab was lower than in previous studies. The ECOG score, LDH values, the presence of liver metastases and the NLR were independent prognostic factors for survival.