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纳武利尤单抗治疗转移性黑色素瘤的疗效和安全性:真实世界实践。

Efficacy and safety of nivolumab in metastatic melanoma: real-world practice.

机构信息

Department of Dermatology, Nantes University Hospital.

PIMESP-SEB, St Jacques Hospital.

出版信息

Eur J Dermatol. 2019 Jun 1;29(3):315-321. doi: 10.1684/ejd.2019.3558.

Abstract

BACKGROUND

Anti-PD1 antibodies have revolutionized the management of patients with advanced melanoma. In clinical trials, the efficacy of nivolumab is being tested in selected populations of patients.

OBJECTIVES

The aim of this study was to analyse the efficacy and safety of nivolumab in patients with advanced melanoma under real-life conditions.

MATERIALS AND METHODS

A retrospective, observational study was conducted in patients treated with nivolumab for advanced melanoma included in the RIC-Mel network. Overall survival and progression-free survival (PFS) were assessed using the Kaplan-Meier method.

RESULTS

Eighty-seven patients were included with a median follow-up of 31 months. The median PFS was 13 months (95% CI: 7-28). Objective response rate was 33.3%. Among patients achieving a complete response, the response was maintained after treatment discontinuation in 80.7% of patients for a median duration of 21.7 months. Multivariate analysis showed that an increased lactate dehydrogenase level (p = 0.03; HR: 1.21; 95% CI: 1.02-1.45) and brain metastases (p = 0.024; HR: 2.78; 95% CI: 1.14-6.77) were correlated with a decrease in PFS. Grade 3 or 4 adverse events were found in 10.3% of patients.

CONCLUSION

Based on our study, the efficacy and safety of nivolumab in patients with advanced melanoma are consistent with previously published data.

摘要

背景

抗 PD-1 抗体彻底改变了晚期黑色素瘤患者的治疗方式。在临床试验中,nivolumab 在特定患者群体中的疗效正在被检验。

目的

本研究旨在分析在真实环境下,nivolumab 治疗晚期黑色素瘤患者的疗效和安全性。

材料和方法

这是一项在 RIC-Mel 网络中接受 nivolumab 治疗的晚期黑色素瘤患者中进行的回顾性、观察性研究。使用 Kaplan-Meier 方法评估总生存期和无进展生存期(PFS)。

结果

共纳入 87 例患者,中位随访时间为 31 个月。中位 PFS 为 13 个月(95%CI:7-28)。客观缓解率为 33.3%。在达到完全缓解的患者中,80.7%的患者在停药后继续保持缓解,缓解持续时间的中位数为 21.7 个月。多变量分析显示,乳酸脱氢酶水平升高(p=0.03;HR:1.21;95%CI:1.02-1.45)和脑转移(p=0.024;HR:2.78;95%CI:1.14-6.77)与 PFS 降低相关。发现 10.3%的患者出现 3 级或 4 级不良事件。

结论

根据我们的研究,nivolumab 治疗晚期黑色素瘤患者的疗效和安全性与先前发表的数据一致。

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