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纳武利尤单抗治疗后进展的罕见黑色素瘤亚型患者的安全性和疗效:一项单臂、开放标签、Ⅱ期研究(CheckMate 172)。

Safety and efficacy of nivolumab in patients with rare melanoma subtypes who progressed on or after ipilimumab treatment: a single-arm, open-label, phase II study (CheckMate 172).

机构信息

Department of Medical Oncology, Mount Vernon Cancer Centre, London, United Kingdom.

Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, Italy.

出版信息

Eur J Cancer. 2019 Sep;119:168-178. doi: 10.1016/j.ejca.2019.07.010. Epub 2019 Aug 21.

DOI:10.1016/j.ejca.2019.07.010
PMID:31445199
Abstract

BACKGROUND

Nivolumab has been widely studied in non-acral cutaneous melanoma; however, limited data are available in other melanoma subtypes. We report outcomes by melanoma subtype in patients who received nivolumab after progression on prior ipilimumab.

PATIENTS AND METHODS

CheckMate 172 was a phase II, single-arm, open-label, multicentre study that evaluated nivolumab in patients with advanced melanoma who progressed on or after ipilimumab. Patients received 3 mg/kg of nivolumab, every 2 weeks for up to 2 years. The primary end-point was incidence of grade ≥3, treatment-related select adverse events (AEs).

RESULTS

Among 1008 treated patients, we report data on patients with non-acral cutaneous melanoma (n = 723 [71.7%]), ocular melanoma (n = 103 [10.2%]), mucosal melanoma (n = 63 [6.3%]), acral cutaneous melanoma (n = 55 [5.5%]) and other melanoma subtypes (n = 64 [6.3%]). There were no meaningful differences in the incidence of grade ≥3, treatment-related select AEs among melanoma subtypes or compared with the total population. No new safety signals emerged. At a minimum follow-up of 18 months, median overall survival was 25.3 months for non-acral cutaneous melanoma and 25.8 months for acral cutaneous melanoma, with 18-month overall survival rates of 57.5% and 59.0%, respectively. Median overall survival was 12.6 months for ocular melanoma and 11.5 months for mucosal melanoma, with 18-month overall survival rates of 34.8% and 31.5%, respectively.

CONCLUSIONS

The safety profile of nivolumab after ipilimumab is similar across melanoma subtypes. Compared with non-acral cutaneous melanoma, patients with acral cutaneous melanoma had similar survival outcomes, whereas those with ocular and mucosal melanoma had lower median overall survival. CLINICALTRIALS.

GOV ID

NCT02156804.

摘要

背景

纳武利尤单抗已在非肢端皮肤黑色素瘤中广泛研究;然而,其他黑色素瘤亚型的相关数据有限。我们报告了先前接受伊匹单抗治疗后进展的患者中,按黑色素瘤亚型使用纳武利尤单抗的结果。

患者和方法

CheckMate 172 是一项 II 期、单臂、开放标签、多中心研究,评估了纳武利尤单抗在先前接受过或正在接受伊匹单抗治疗后进展的晚期黑色素瘤患者中的疗效。患者接受 3 mg/kg 纳武利尤单抗,每 2 周一次,最长 2 年。主要终点为 3 级及以上、治疗相关的选择性不良事件(AE)的发生率。

结果

在 1008 例接受治疗的患者中,我们报告了非肢端皮肤黑色素瘤(n=723[71.7%])、眼部黑色素瘤(n=103[10.2%])、黏膜黑色素瘤(n=63[6.3%])、肢端皮肤黑色素瘤(n=55[5.5%])和其他黑色素瘤亚型(n=64[6.3%])患者的数据。各亚型之间或与总体人群相比,3 级及以上、治疗相关的选择性 AE 的发生率无显著差异。未出现新的安全性信号。在 18 个月的最小随访中,非肢端皮肤黑色素瘤的中位总生存期为 25.3 个月,肢端皮肤黑色素瘤为 25.8 个月,18 个月的总生存率分别为 57.5%和 59.0%。眼部黑色素瘤的中位总生存期为 12.6 个月,黏膜黑色素瘤为 11.5 个月,18 个月的总生存率分别为 34.8%和 31.5%。

结论

纳武利尤单抗在伊匹单抗之后的安全性在黑色素瘤亚型之间相似。与非肢端皮肤黑色素瘤相比,肢端皮肤黑色素瘤患者的生存结局相似,而眼部和黏膜黑色素瘤患者的中位总生存期较低。临床试验。

gov ID:NCT02156804。

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