Read Tavis A, Smith Aaron, Thomas Janine, David Michael, Foote Matthew, Wagels Michael, Barbour Andrew, Smithers B Mark
Queensland Melanoma Project, Princess Alexandra Hospital, Brisbane, Australia.
Faculty of Medicine, The University of Queensland, Southern Clinical School, Princess Alexandra Hospital, Brisbane, Australia.
J Surg Oncol. 2018 Mar;117(4):579-587. doi: 10.1002/jso.24921. Epub 2018 Mar 12.
Patients with in-transit melanoma metastases frequently experience high rates of recurrence, limited overall survival and reduced quality of life. After promising results within a Phase II, multi-center study, PV-10 treatment was continued at our institution for patients with in-transit disease.
An open-label, non-randomized, prospective study was performed at the Princess Alexandra Hospital, Queensland, Australia. Patients were treated with PV-10 in accordance with the treatment protocol established during a previous Phase II study. The primary outcome was the complete response of treated lesions.
Forty-five patients were enrolled over a total of 82 treatment episodes from July 2008 to December 2015. With sequential PV-10 treatments the complete response rate was 42% and overall response rate 87% on an intention to treat analysis. The median follow-up duration was 22 months and the median overall survival was 25 months from first PV-10 treatment. Having fewer than 15 metastases at the time of treatment was associated with a complete response (P = 0.03).
Intralesional PV-10 provided rapid lesion-specific ablation of melanoma metastases with well-tolerated local effects and minimal systemic adverse events. This therapy should be considered for patients with multiple accessible deposits within the spectrum of low to moderate disease volume.
处于转移期的黑色素瘤患者经常经历高复发率、有限的总生存期以及生活质量下降。在一项II期多中心研究取得有前景的结果后,我们机构继续对处于转移期疾病的患者采用PV-10治疗。
在澳大利亚昆士兰州亚历山德拉公主医院开展了一项开放标签、非随机、前瞻性研究。患者按照先前II期研究制定的治疗方案接受PV-10治疗。主要结局是治疗病灶的完全缓解。
从2008年7月至2015年12月,共82个治疗疗程,纳入了45例患者。按照意向性分析,随着PV-10的序贯治疗,完全缓解率为42%,总缓解率为87%。从首次接受PV-10治疗起,中位随访时间为22个月,中位总生存期为25个月。治疗时转移灶少于15个与完全缓解相关(P = 0.03)。
病灶内注射PV-10可对黑色素瘤转移灶进行快速的病灶特异性消融,局部耐受性良好,全身不良事件极少。对于疾病体积处于低至中等范围且有多个可触及病灶的患者,应考虑这种治疗方法。