Dermatology Unit, Lyon Sud University Hospital, Pierre Bénite, France.
Cancer Research Center of Lyon, Claude Bernard Lyon-1 University, INSERM1052, CNRS 5286, Centre Leon Berard, Lyon, France.
Cancer Med. 2021 May;10(10):3155-3164. doi: 10.1002/cam4.3760. Epub 2021 May 1.
Cytotoxic chemotherapy (CC) is currently used in metastatic melanoma after patients have developed resistance to immune checkpoint inhibitors (ICI) and/or Mitogen-Activated Protein Kinase inhibitors (MAPKi). We sought to evaluate if a previous treatment by ICI or MAPKi influences clinical outcomes in patients treated by CC in metastatic melanoma.
Eighty-eight patients with a metastatic melanoma, treated by CC after a previous treatment by ICI or MAPKi between January 2009 and October 2019, were retrospectively analyzed. Progression-Free-Survival (PFS), Overall Survival (OS), Overall Response Rate (ORR), and Disease Control Rate (DCR) were evaluated in patients treated by CC according to their prior treatment by ICI or MAPKi.
Patients treated by CC after ICI tended to have a better median PFS (2.81 months (2.39-5.30) versus 2.40 months (0.91-2.75), p = 0.023), median OS (6.03 months (3.54-11.54) versus 4.44 months (1.54-8.59), p = 0.27), DCR (26.0% vs. 10.5%, p = 0.121) and ORR (22.0% vs. 7.9% p = 0.134) than those previously treated by MAPKi.
A prior treatment by an MAPKi may be associated with a worse response to CC than ICI, and further investigations should be performed to confirm if there is a clinical benefit to propose CC in this setting.
细胞毒性化疗（CC）目前用于转移性黑色素瘤患者，这些患者在对免疫检查点抑制剂（ICI）和/或丝裂原活化蛋白激酶抑制剂（MAPKi）产生耐药后。我们旨在评估在转移性黑色素瘤患者中，ICI 或 MAPKi 先前的治疗是否会影响 CC 治疗的临床结局。
回顾性分析了 2009 年 1 月至 2019 年 10 月期间，88 例接受 ICI 或 MAPKi 治疗后接受 CC 治疗的转移性黑色素瘤患者。根据患者接受 CC 治疗前是否接受过 ICI 或 MAPKi 治疗，评估 CC 治疗患者的无进展生存期（PFS）、总生存期（OS）、总缓解率（ORR）和疾病控制率（DCR）。
与先前接受 MAPKi 治疗的患者相比，接受 CC 治疗的患者 PFS 中位数（2.81 个月（2.39-5.30）与 2.40 个月（0.91-2.75），p=0.023）、OS 中位数（6.03 个月（3.54-11.54）与 4.44 个月（1.54-8.59），p=0.27）、DCR（26.0% vs. 10.5%，p=0.121）和 ORR（22.0% vs. 7.9%，p=0.134）更好。
MAPKi 的先前治疗可能与 CC 治疗的反应较差相关，应进一步进行研究以确定在此情况下 CC 是否具有临床获益。
