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III/IV期黑色素瘤辅助治疗的处方模式、复发率及毒性率——一项真实世界单中心分析

Prescription Patterns, Recurrence, and Toxicity Rates of Adjuvant Treatment for Stage III/IV Melanoma-A Real World Single-Center Analysis.

作者信息

Hoffmann Michèle, Hayoz Stefanie, Özdemir Berna C

机构信息

Department of Medical Oncology, Inselspital Bern, Bern University Hospital, University of Bern, 3012 Bern, Switzerland.

Swiss Group for Clinical Cancer Research, 3008 Bern, Switzerland.

出版信息

Biology (Basel). 2022 Mar 10;11(3):422. doi: 10.3390/biology11030422.

Abstract

Approved adjuvant treatment options for stage III melanoma are the immune checkpoint inhibitors (ICI) pembrolizumab and nivolumab, and in presence of a BRAF V600E/K mutation additionally dabrafenib in combination with trametinib (BRAFi/MEKi). This study aims to describe prescription patterns and recurrence and toxicity rates of adjuvant-treated melanoma patients from the Cancer Center of the University Hospital Bern, Switzerland. One hundred and nine patients with an indication for adjuvant treatment were identified. Five (4.6%) had contraindications and, as such, were not proposed any adjuvant treatment, while 10 patients (9.2%) declined treatment. BRAF status was known for 91 (83.5%) patients. Of 40 (36.7%) patients with BRAF V600E/K melanoma, pembrolizumab was prescribed to 18 (45.0%), nivolumab to 16 (40.0%), and dabrafenib/trametinib to three (7.5%) patients. Grade 3-4 toxicity was reported in 18.9% and 16.7% of all the patients treated with pembrolizumab and nivolumab, respectively. No toxicities were observed for dabrafenib/trametinib. Thirty-eight percent of the patients treated with pembrolizumab and 40.0% of those treated with nivolumab relapsed. No relapses were reported for dabrafenib/trametinib. Prescription patterns indicate a clear preference for adjuvant ICI treatment.

摘要

III期黑色素瘤的批准辅助治疗方案是免疫检查点抑制剂(ICI)派姆单抗和纳武单抗,对于存在BRAF V600E/K突变的患者,还可使用达拉非尼联合曲美替尼(BRAF抑制剂/MEK抑制剂)。本研究旨在描述瑞士伯尔尼大学医院癌症中心接受辅助治疗的黑色素瘤患者的处方模式、复发率和毒性率。确定了109例有辅助治疗指征的患者。其中5例(4.6%)有禁忌症,因此未建议进行任何辅助治疗,而10例患者(9.2%)拒绝治疗。91例(83.5%)患者的BRAF状态已知。在40例(36.7%)BRAF V600E/K黑色素瘤患者中,18例(45.0%)患者使用派姆单抗,16例(40.0%)患者使用纳武单抗,3例(7.5%)患者使用达拉非尼/曲美替尼。接受派姆单抗和纳武单抗治疗的所有患者中,分别有18.9%和16.7%报告了3-4级毒性。达拉非尼/曲美替尼未观察到毒性反应。接受派姆单抗治疗的患者中有38%复发,接受纳武单抗治疗的患者中有40.0%复发。达拉非尼/曲美替尼未报告复发情况。处方模式表明对辅助ICI治疗有明显偏好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c57/8945449/b486fee2b4e6/biology-11-00422-g001.jpg

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