Toulsie Ramtohul1, Axel Cohen2, Manuel Rodrigues3,4, Sophie Piperno-Neumann3, Luc Cabel3, Nathalie Cassoux5,6, Livia Lumbroso-Le Rouic5, Denis Malaise5,7, Sophie Gardrat4,8, Gaëlle Pierron9, Pascale Mariani10, Vincent Servois11. 1. Department of Radiology, Institut Curie, Paris, PSL Research University, Paris, France. toulsie.ramtohul@curie.fr. 2. Department of Radiology, Institut Curie, Paris, PSL Research University, Paris, France. 3. Department of Medical Oncology, Institut Curie, PSL Research University, Paris and St. Cloud, Paris, France. 4. INSERM U830, DNA Repair and Uveal Melanoma (D.R.U.M.), Paris, France. 5. Department of Ocular Oncology, Institut Curie, PSL Research University, Paris, France. 6. UMR 144 CNRS, Université de Paris, Paris, France. 7. INSERM U1288, PSL Research University, Laboratoire d'Imagerie Translationnelle en Oncologie, 91400, Orsay, France. 8. Department of Biopathology, Institut Curie, PSL Research University, Paris, France. 9. Somatic Genetic Unit, Department of Genetics, Institut Curie, PSL University, Paris, France. 10. Department of Surgical Oncology, Institut Curie, PSL Research University, Paris, France. 11. Department of Radiology, Institut Curie, Paris, PSL Research University, Paris, France. vincent.servois@curie.fr.
Abstract
BACKGROUND: The RECIST-based response variably matches the clinical benefit of systemic therapies for liver metastatic uveal melanoma (LMUM). The aims were to determine whether the tumour growth rate (TGR) can help predict the survival in patients with LMUM and to provide information for the management of first-line systemic treatment. METHODS: This retrospective study included 147 (training: n = 110, validation: n = 37) patients with LMUM treated with first-line systemic treatment between 2010 and 2021. Two TGR-derived parameters were calculated, TGR0 and TGR3m. Multivariate Cox analyses identified independent predictors of progression-free survival (PFS) and overall survival (OS). RESULTS: TGR3m was a strong independent prognostic factor of PFS and OS (p < 0.001). The RECIST-based response was no longer significant in the OS analyses. Only immunotherapy regimens correlated with higher OS (HR = 0.2; 95% CI, 0.1-0.5; p < 0.001) in the low-TGR3m (≤50%/m) subgroup. These findings were confirmed in the validation cohort. TGR0, disease-free interval (DFI), and the sum of target lesions at baseline were predictive factors of low TGR3m. DISCUSSION: The use of TGR3m would improve tumour assessment by identifying patients who would benefit from first-line immunotherapy regimens despite PD. TGR0, DFI and the sum of target lesions were correlated with TGR3m, which can support first-line treatment decision-making for immunotherapy.
BACKGROUND: The RECIST-based response variably matches the clinical benefit of systemic therapies for liver metastatic uveal melanoma (LMUM). The aims were to determine whether the tumour growth rate (TGR) can help predict the survival in patients with LMUM and to provide information for the management of first-line systemic treatment. METHODS: This retrospective study included 147 (training: n = 110, validation: n = 37) patients with LMUM treated with first-line systemic treatment between 2010 and 2021. Two TGR-derived parameters were calculated, TGR0 and TGR3m. Multivariate Cox analyses identified independent predictors of progression-free survival (PFS) and overall survival (OS). RESULTS: TGR3m was a strong independent prognostic factor of PFS and OS (p < 0.001). The RECIST-based response was no longer significant in the OS analyses. Only immunotherapy regimens correlated with higher OS (HR = 0.2; 95% CI, 0.1-0.5; p < 0.001) in the low-TGR3m (≤50%/m) subgroup. These findings were confirmed in the validation cohort. TGR0, disease-free interval (DFI), and the sum of target lesions at baseline were predictive factors of low TGR3m. DISCUSSION: The use of TGR3m would improve tumour assessment by identifying patients who would benefit from first-line immunotherapy regimens despite PD. TGR0, DFI and the sum of target lesions were correlated with TGR3m, which can support first-line treatment decision-making for immunotherapy.
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