Lebbé C, Weber J S, Maio M, Neyns B, Harmankaya K, Hamid O, O'Day S J, Konto C, Cykowski L, McHenry M B, Wolchok J D
Department of Dermatology, APHP, CIC, U976 Hôpital Saint-Louis University Paris Diderot, Paris, France.
Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA.
Ann Oncol. 2014 Nov;25(11):2277-2284. doi: 10.1093/annonc/mdu441. Epub 2014 Sep 10.
This report provides a survival update at a follow-up of >5 years (5.5-6 years) for patients with advanced melanoma who previously received ipilimumab in phase II clinical trials. Safety and efficacy data following ipilimumab retreatment are also reported.
Patients who previously received ipilimumab 0.3, 3, or 10 mg/kg in one of six phase II trials (CA184-004, CA184-007, CA184-008, CA184-022, MDX010-08, and MDX010-15) were eligible to enroll in the companion study, CA184-025. Upon enrollment, patients initially received ipilimumab retreatment, extended maintenance therapy, or were followed for survival only. Overall survival (OS) rates were evaluated in patients from studies CA184-004, CA184-007, CA184-008, and CA184-022. Safety and best overall response during ipilimumab retreatment at 10 mg/kg were assessed in study CA184-025.
Five-year OS rates for previously treated patients who received ipilimumab induction at 0.3, 3, or 10 mg/kg were 12.3%, 12.3%-16.5%, and 15.5%-28.4%, respectively. Five-year OS rates for treatment-naive patients who received ipilimumab induction at 3 or 10 mg/kg were 26.8% and 21.4%-49.5%, respectively. Little to no change in OS was observed from year 5 up to year 6. The objective response rate among retreated patients was 23%. Grade 3/4 immune-related adverse events occurred in 25%, 5.9%, and 13.2% of retreated patients who initially received ipilimumab 0.3, 3, and 10 mg/kg, with the most common being observed in the skin (4.2%, 2.9%, 3.8%) and gastrointestinal tract (12.5%, 2.9%, 3.8%), respectively.
At a follow-up of 5-6 years, ipilimumab continues to demonstrate durable, long-term survival in a proportion of patients with advanced melanoma. In some patients, ipilimumab retreatment can re-establish disease control with a safety profile that is comparable with that observed during ipilimumab induction. Further studies are needed to determine the contribution of ipilimumab retreatment to OS.
NCT00162123.
本报告提供了在II期临床试验中先前接受过伊匹单抗治疗的晚期黑色素瘤患者超过5年(5.5 - 6年)随访期的生存情况更新。同时也报告了伊匹单抗再次治疗后的安全性和疗效数据。
在六项II期试验(CA184 - 004、CA184 - 007、CA184 - 008、CA184 - 022、MDX010 - 08和MDX010 - 15)之一中,先前接受过0.3、3或10 mg/kg伊匹单抗治疗的患者有资格参加配套研究CA184 - 025。入组后,患者最初接受伊匹单抗再次治疗、延长维持治疗或仅进行生存随访。对来自CA184 - 004、CA184 - 007、CA184 - 008和CA184 - 022研究的患者评估总生存率(OS)。在CA184 - 025研究中评估10 mg/kg伊匹单抗再次治疗期间的安全性和最佳总体缓解情况。
先前接受治疗且分别接受0.3、3或10 mg/kg伊匹单抗诱导治疗的患者5年总生存率分别为12.3%、12.3% - 16.5%和15.5% - 28.4%。未接受过治疗且接受3或10 mg/kg伊匹单抗诱导治疗的患者5年总生存率分别为26.8%和21.4% - 49.5%。从第5年到第6年,总生存率几乎没有变化。再次治疗患者的客观缓解率为23%。最初接受0.3、3和10 mg/kg伊匹单抗治疗的再次治疗患者中,3/4级免疫相关不良事件的发生率分别为25%、5.9%和13.2%,最常见的分别出现在皮肤(4.2%、2.9%、3.8%)和胃肠道(12.5%、2.9%、3.8%)。
在5 - 6年的随访中,伊匹单抗在一部分晚期黑色素瘤患者中继续显示出持久的长期生存。在一些患者中,伊匹单抗再次治疗可重新建立疾病控制,其安全性与伊匹单抗诱导治疗期间观察到的相当。需要进一步研究以确定伊匹单抗再次治疗对总生存率的贡献。
NCT00162123