AI Article Synopsis
- When patients with metastatic melanoma do not respond to PD-1 inhibitors, ipilimumab may be a viable second-line treatment option in the absence of clinical trials.
- A study of 44 patients who received ipilimumab showed significant differences in overall survival based on genetic mutations (BRAF, NRAS) and the presence of brain metastases, with wildtype patients having the best survival rate.
- The findings suggest that ipilimumab remains an effective therapy especially for those without brain metastases, highlighting the importance of genetic profile in treatment outcome.
Article Abstract
Background: When monotherapy with PD-1 inhibitors in metastatic melanoma fails, there are currently no standard second-line choices. In case of the unavailability of clinical trials, ipilimumab represents a possible alternative treatment.
Methods: We collected data of 44 patients who received ipilimumab after the failure of PD-1 inhibitors from July 2017 to May 2023 at our Institute. Overall survival (OS), progression-free survival (PFS), and post-progression survival (PPS) based on BRAF or NRAS mutation status, sex, and the presence of brain metastases were estimated using the Kaplan-Meier method. Cox regression was used to evaluate independence in multivariate analysis. The objective response rate (ORR) was estimated based on RECIST 1.1.
Results: Among the 44 patients enrolled in this study, 28 BRAF-wildtype, 9 BRAF-mutated, and 7 NRAS-mutated patients were identified. OS analysis showed a significant difference between wildtype and BRAF- or NRAS-mutated patients: 23.2 months vs 5.3 and 4.59, respectively, = 0.017. The presence of brain metastases and BRAF or NRAS mutation were independent factors for mortality in multivariate analysis.
Conclusions: In case of failure to enroll patients in innovative clinical trials, second-line ipilimumab still represents an effective therapy in patients with metastatic wildtype melanoma and in the absence of brain metastases.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475497 | PMC |
| http://dx.doi.org/10.3390/cancers16193397 | DOI Listing |
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