Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/16673
Title: Efficacy of anti-PD-1 therapy in patients with melanoma brain metastases
Authors: Parakh, Sagun;Park, John J;Mendis, Shehara;Rai, Rajat;Xu, Wen;Lo, Serigne;Drummond, Martin;Rowe, Catherine;Wong, Annie;McArthur, Grant;Haydon, Andrew;Andrews, Miles C;Cebon, Jonathan S;Guminski, Alex;Kefford, Richard F;Long, Georgina V;Menzies, Alexander M;Klein, Oliver;Carlino, Matteo S
Issue Date: Jun-2017
EDate: 2017-05-18
Citation: British Journal of Cancer 2017; 116(12): 1558-1563
Abstract: BACKGROUND: There is limited data on the efficacy of anti-programmed death 1 (PD-1) antibodies in patients (pts) with melanoma brain metastasis (BM), particularly those which are symptomatic. METHOD: We retrospectively assessed pts with melanoma BM treated with PD-1 antibodies, nivolumab and pembrolizumab. Clinicopathologic and treatment parameters were collected and outcomes determined for intracranial (IC) response rate (RR) using a modified RECIST criteria, with up to five IC target lesions used to determine IC response, disease control rate (DCR) and progression-free survival (PFS). RESULTS: A total of 66 pts were identified with a median follow up of 7.0 months (range 0.8-24.5 months). A total of 68% were male and 45% BRAF V600 mutation positive. At PD-1 antibody commencement, 50% had an elevated LDH; 64% had local therapy to BM prior to commencing anti-PD1, of which 5% had surgical resection, 14% stereotactic radiosurgery (SRS), 18% whole-brain radiotherapy (WBRT), 27% had surgery and radiotherapy. Twenty-one per cent started anti-PD-1 as first line systemic therapy. No pt had prior anti-PD-1 treatment. The IC overall RR was 21 and DCR 56%. Responses occurred in 21% of pts with symptomatic BM. The median OS was 9.9 months (95% CI 6.93-17.74). Pts with symptomatic BM had shorter PFS than those without symptoms (2.7 vs 7.4 months, P=0.035) and numerically shorter OS (5.7 vs 13.0 months, P=0.068). Pts requiring corticosteroids also had a numerically shorter PFS (3.2 vs 7.4 months, P=0.081) and OS (4.8 vs 13.1 months, P=0.039). CONCLUSIONS: IC responses to anti-PD-1 antibodies occur in pts with BM, including those with symptomatic BM requiring corticosteroids. Prospective trials evaluating anti-PD-1 therapy in pts with BM are underway.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16673
DOI: 10.1038/bjc.2017.142
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/28524161
Type: Journal Article
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.