Szatkowska Lidia, Sieczek Jan, Tekiela Katarzyna, Ziętek Marcin, Stachyra-Strawa Paulina, Cisek Paweł, Matkowski Rafał
Clinical Department of Cardiology, 4th Military Hospital, Rudolfa Weigla 5, 50-981 Wrocław, Poland.
Department of Orthopedic Surgery, Provincial Specialist Hospital, Kamieńskiego 73A, 51-124 Wrocław, Poland.
Cancers (Basel). 2022 Mar 25;14(7):1672. doi: 10.3390/cancers14071672.
Background: This study assessed risk factors and the results of treatment with anti-PD-1 antibodies and BRAF/MEK inhibitors for advanced malignant melanoma. Methods: A retrospective analysis was performed on 52 patients treated with immunotherapy and BRAF/MEK inhibitors for disseminated malignant melanoma. Results: The median follow-up was 31 months (6−108 months). The median PFS1 was 6 months (1−44 months). Second-line systemic treatment was applied in 27 patients (52%). The median PFS2 was 2 months (0−27 months), and the median OS was 31 months (6−108 months). Among the analyzed risk factors, only the presence of the BRAF mutation was statistically significant for disease recurrence after surgery. In patients undergoing anti-BRAF/MEK therapy, the median PFS1 was 7 months, and in patients undergoing mono-immunotherapy, 4 months. The 12- and 24-month PFS1 rates in the group treated with BRAF inhibitors were 29 and 7%, respectively, and in patients treated with mono-immunotherapy 13 and 0%, respectively (Z = 1.998, p = 0.04). The type of treatment used had no effect on OS (Z = 0.237, p > 0.05). Conclusion: Patients with the V600 mutation should be closely monitored. In the event of disease recurrence, treatment with BRAF/MEK inhibitors should be considered. The type of treatment used has no effect on OS.
本研究评估了晚期恶性黑色素瘤的危险因素以及抗程序性死亡蛋白1(PD-1)抗体和BRAF/MEK抑制剂的治疗结果。方法:对52例接受免疫治疗和BRAF/MEK抑制剂治疗的播散性恶性黑色素瘤患者进行回顾性分析。结果:中位随访时间为31个月(6 - 108个月)。中位无进展生存期1(PFS1)为6个月(1 - 44个月)。27例患者(52%)接受了二线全身治疗。中位无进展生存期2(PFS2)为2个月(0 - 27个月),中位总生存期(OS)为31个月(6 - 108个月)。在分析的危险因素中,只有BRAF突变的存在对术后疾病复发具有统计学意义。接受抗BRAF/MEK治疗的患者,中位PFS1为7个月,接受单免疫治疗的患者为4个月。BRAF抑制剂治疗组的12个月和24个月PFS1率分别为29%和7%,单免疫治疗患者分别为13%和0%(Z = 1.998,p = 0.04)。所用治疗类型对OS无影响(Z = 0.237,p > 0.05)。结论:携带V600突变的患者应密切监测。一旦疾病复发,应考虑使用BRAF/MEK抑制剂治疗。所用治疗类型对OS无影响。