Zur Seitennavigation oder mit Tastenkombination für den accesskey-Taste und Taste 1 
Zum Seiteninhalt oder mit Tastenkombination für den accesskey und Taste 2 
Startseite    Anmelden     
   Hilfe  Trennstrich  Sitemap  Trennstrich  Impressum  Trennstrich  Datenschutz  Trennstrich  node1  Trennstrich  Switch to english language

Publikation: Zeitschriftenartikel

Combined immunotherapy with nivolumab and ipilimumab with and without local therapy in patients with melanoma brain metastasis


Grunddaten

Titel Combined immunotherapy with nivolumab and ipilimumab with and without local therapy in patients with melanoma brain metastasis
Untertitel a DeCOG* study in 380 patients
Erscheinungsjahr 2020
Band 8
Heft-Nr. 1
Jahr 2020
Publikationsform Elektronische Ressource
Publikationsart Zeitschriftenartikel
Sprache Englisch
DOI 10.1136/jitc-2019-000333
Letzte Änderung 11.01.2022 06:03:06
Bearbeitungsstatus durch UB Rostock abschließend validiert
Dauerhafte URL http://purl.uni-rostock.de/fodb/pub/67092
Links zu Katalogen Diese Publikation in der Universitätsbibliographie Diese Publikation im GBV-Katalog

Abstract

Background: Nivolumab combined with ipilimumab have shown activity in melanoma brain metastasis (MBM). However, in most of the clinical trials investigating immunotherapy in this subgroup, patients with symptomatic MBM and/or prior local brain radiotherapy were excluded. We studied the efficacy of nivolumab plus ipilimumab alone or in combination with local therapies regardless of treatment line in patients with asymptomatic and symptomatic MBM. Methods: Patients with MBM treated with nivolumab plus ipilimumab in 23 German Skin Cancer Centers between April 2015 and October 2018 were investigated. Overall survival (OS) was evaluated by Kaplan-Meier estimator and univariate and multivariate Cox proportional hazard analyses were performed to determine prognostic factors associated with OS. Results: Three hundred and eighty patients were included in this study and 31% had symptomatic MBM (60/193 with data available) at the time of start nivolumab plus ipilimumab. The median follow-up was 18 months and the 2 years and 3 years OS rates were 41% and 30%, respectively. We identified the following independently significant prognostic factors for OS: elevated serum lactate dehydrogenase and protein S100B levels, number of MBM and Eastern Cooperative Oncology Group performance status. In these patients treated with checkpoint inhibition first-line or later, in the subgroup of patients with BRAFV600-mutated melanoma we found no differences in terms of OS when receiving first-line either BRAF and MEK inhibitors or nivolumab plus ipilimumab (p=0.085). In BRAF wild-type patients treated with nivolumab plus ipilimumab in first-line or later there was also no difference in OS (p=0.996). Local therapy with stereotactic radiosurgery or surgery led to an improvement in OS compared with not receiving local therapy (p=0.009), regardless of the timepoint of the local therapy. Receiving combined immunotherapy for MBM in first-line or at a later time point made no difference in terms of OS in this study population (p=0.119). Conclusion: Immunotherapy with nivolumab plus ipilimumab, particularly in combination with stereotactic radiosurgery or surgery improves OS in asymptomatic and symptomatic MBM.

Autoren

Amaral, Teresa
Kiecker, Felix
Schäfer, Sarah
Stege, Henner Maximilian
Kähler, Katharina C.
Terheyden, Patrick
Gesierich, Anja Heike
Gutzmer, Ralf
Haferkamp, Sebastian
Utikal, Jochen
Berking, Carola
Rafei-Shamsabadi, David Ali
Reinhardt, Lydia
Meier, Friedegund
Karoglan, Ante
Posch, Christian
Gambichler, Thilo
Pföhler, Claudia Ursula
Thoms, Kai-Martin
Tietze, Julia Katharina
Debus, Dirk
Herbst, Rudolf
Emmert, Steffen Link zur UB Rostock Link zum GBV-Katalog
Loquai, Carmen
Hassel, Jessica C.
Meiß, Frank
Tueting, Thomas
Heinrich, Vanessa
Eigentler, Thomas
Garbe, Claus
Zimmer, Lisa

Einrichtung

UMR/Klinik und Poliklinik für Dermatologie und Venerologie (DUK)