Stefan Diem1, Benjamin Kasenda1, Juan Martin-Liberal2, Alexander Lee1, Dharmisha Chauhan1, Martin Gore1, James Larkin3. 1. Department of Medical Oncology, Royal Marsden Hospital NHS Foundation Trust, Fulham Road, London SW36JJ, United Kingdom. 2. Department of Medical Oncology, Royal Marsden Hospital NHS Foundation Trust, Fulham Road, London SW36JJ, United Kingdom; Department of Medical Oncology, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Pg Vall d'Hebron, 119-129, 08035 Barcelona, Spain. 3. Department of Medical Oncology, Royal Marsden Hospital NHS Foundation Trust, Fulham Road, London SW36JJ, United Kingdom. Electronic address: james.larkin@rmh.nhs.uk.
Abstract
BACKGROUND: Immunotherapies like the cytotoxic T-lymphocyte antigen 4 inhibitor ipilimumab show durable clinical benefit in patients with advanced melanoma. Reliable prognostic markers and risk scores in the era of immunotherapy are still lacking. PATIENTS AND METHODS: We collected characteristics and outcomes on 134 patients with metastatic melanoma treated with ipilimumab between 2011 and 2014 at a single centre. Cox regression including multivariable fractional polynomials was used to identify independent markers for overall survival (OS). Internal model validation was done using bootstrap procedures. RESULTS: After a median follow-up of 16.1 months the median OS was 7.1 months (95% confidence interval [CI], 6.5-9.8). Nineteen of 134 patients (14.2%) had tumour remissions, 16 partial and 3 complete; 75% had progressive disease. We identified three independent adverse factors for OS: elevated lactate dehydrogenase (LDH) (hazard ratio [HR] 1.03, 95% CI 1.02-1.04), Eastern Cooperative Oncology Group performance status >0 (HR 1.91, 95% CI 1.10-3.30), and number of organs involved (NOI) (HR 1.51, 95% CI 1.22-1.86). To build an easy-to-apply risk score, we dichotomized LDH (>upper limit of normal) and NOI (>2) to built 3 prognostic groups: favourable (no adverse factors, N = 17), intermediate (1 adverse factor, N = 38), and poor prognosis (≥2 adverse factors, N = 73). Respective 12 and 18-month OS for the risk groups were: 85% and 73% (favourable), 41% and 29% (intermediate), and 12% and 6% (poor) (p < 0.001). CONCLUSION: We propose a simple prognostic score for survival in patients with advanced melanoma treated with ipilimumab using readily available clinical parameters.
BACKGROUND: Immunotherapies like the cytotoxic T-lymphocyte antigen 4 inhibitor ipilimumab show durable clinical benefit in patients with advanced melanoma. Reliable prognostic markers and risk scores in the era of immunotherapy are still lacking. PATIENTS AND METHODS: We collected characteristics and outcomes on 134 patients with metastatic melanoma treated with ipilimumab between 2011 and 2014 at a single centre. Cox regression including multivariable fractional polynomials was used to identify independent markers for overall survival (OS). Internal model validation was done using bootstrap procedures. RESULTS: After a median follow-up of 16.1 months the median OS was 7.1 months (95% confidence interval [CI], 6.5-9.8). Nineteen of 134 patients (14.2%) had tumour remissions, 16 partial and 3 complete; 75% had progressive disease. We identified three independent adverse factors for OS: elevated lactate dehydrogenase (LDH) (hazard ratio [HR] 1.03, 95% CI 1.02-1.04), Eastern Cooperative Oncology Group performance status >0 (HR 1.91, 95% CI 1.10-3.30), and number of organs involved (NOI) (HR 1.51, 95% CI 1.22-1.86). To build an easy-to-apply risk score, we dichotomized LDH (>upper limit of normal) and NOI (>2) to built 3 prognostic groups: favourable (no adverse factors, N = 17), intermediate (1 adverse factor, N = 38), and poor prognosis (≥2 adverse factors, N = 73). Respective 12 and 18-month OS for the risk groups were: 85% and 73% (favourable), 41% and 29% (intermediate), and 12% and 6% (poor) (p < 0.001). CONCLUSION: We propose a simple prognostic score for survival in patients with advanced melanoma treated with ipilimumab using readily available clinical parameters.
Authors: Alice Y Zhou; Daniel Y Wang; Svetlana McKee; Fei Ye; Chun-Che Wen; Debbie E Wallace; Kristin K Ancell; Robert M Conry; Douglas B Johnson Journal: J Surg Oncol Date: 2019-07-02 Impact factor: 3.454
Authors: Felix Peisen; Annika Hänsch; Alessa Hering; Andreas S Brendlin; Saif Afat; Konstantin Nikolaou; Sergios Gatidis; Thomas Eigentler; Teresa Amaral; Jan H Moltz; Ahmed E Othman Journal: Cancers (Basel) Date: 2022-06-17 Impact factor: 6.575
Authors: B M Lang; A Peveling-Oberhag; D Faidt; A M Hötker; V Weyer-Elberich; S Grabbe; C Loquai Journal: Med Oncol Date: 2018-01-31 Impact factor: 3.064
Authors: Johannes Kleemann; Manuel Jäger; Eva Valesky; Stefan Kippenberger; Roland Kaufmann; Markus Meissner Journal: Cancer Manag Res Date: 2021-07-15 Impact factor: 3.989