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纳武利尤单抗联合瑞派利单抗对比纳武利尤单抗单药治疗既往未治疗的不可切除或转移性黑色素瘤患者的健康相关生活质量:RELATIVITY-047试验

Health-related quality of life with nivolumab plus relatlimab versus nivolumab monotherapy in patients with previously untreated unresectable or metastatic melanoma: RELATIVITY-047 trial.

作者信息

Schadendorf Dirk, Tawbi Hussein, Lipson Evan J, Stephen Hodi F, Rutkowski Piotr, Gogas Helen, Lao Christopher D, Grob Jean-Jacques, Moshyk Andriy, Lord-Bessen Jennifer, Hamilton Melissa, Guo Shien, Shi Ling, Keidel Sarah, Long Georgina V

机构信息

Department of Dermatology, University Hospital Essen, German Cancer Consortium, Partner Site Essen and University Alliance Ruhr, Research Center One Health, Essen, Germany.

Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Eur J Cancer. 2023 Jul;187:164-173. doi: 10.1016/j.ejca.2023.03.014. Epub 2023 Mar 22.

DOI:10.1016/j.ejca.2023.03.014
PMID:37167764
Abstract

BACKGROUND

In the phase II/III RELATIVITY-047 trial, a novel fixed-dose combination (FDC) of nivolumab plus relatlimab (NIVO + RELA; a programmed death-1 and a lymphocyte-activation gene 3 inhibitor, respectively) significantly improved progression-free survival (PFS) versus NIVO in patients with previously untreated unresectable or metastatic melanoma (median follow-up, 13.2 months) with stable health-related quality of life (HRQoL), although grade three or four treatment-related adverse events (TRAEs) were more frequent with the combination. Updated HRQoL results (median follow-up, 19.3 months) are presented.

METHODS

Patients were randomised to receive intravenous NIVO + RELA (480 mg and 160 mg, respectively) or NIVO (480 mg) every 4 weeks. HRQoL was assessed using the Functional Assessment of Cancer Treatment-Melanoma (FACT-M) and EQ-5D-3L questionnaires at baseline, before dosing at each treatment cycle, and at follow-up (posttreatment) visits.

RESULTS

Consistent with the initial analysis, HRQoL remained stable with NIVO + RELA on treatment and was similar to that with NIVO. Mean changes from baseline did not exceed clinically meaningful thresholds. HRQoL results were consistent across instruments and scales/subscales. Despite an increased rate of grade three or four TRAEs with NIVO + RELA versus NIVO, the proportion of patients reporting that they were bothered 'quite a bit' or 'very much' by TRAEs was low and comparable between treatments.

CONCLUSION

Results from the RELATIVITY-047 trial show that the PFS benefit with NIVO + RELA FDC over NIVO was obtained with stable patient-reported HRQoL, supporting NIVO + RELA as a first-line treatment option for patients with advanced melanoma.

摘要

背景

在II/III期RELATIVITY-047试验中,对于先前未经治疗的不可切除或转移性黑色素瘤患者(中位随访时间为13.2个月),一种新型的纳武利尤单抗联合relatlimab固定剂量组合(NIVO+RELA;分别为程序性死亡-1抑制剂和淋巴细胞激活基因3抑制剂)与纳武利尤单抗相比,显著改善了无进展生存期(PFS),且健康相关生活质量(HRQoL)保持稳定,尽管联合治疗组3级或4级治疗相关不良事件(TRAEs)更为常见。本文呈现了更新后的HRQoL结果(中位随访时间为19.3个月)。

方法

患者被随机分组,每4周接受一次静脉注射NIVO+RELA(分别为480mg和160mg)或NIVO(480mg)。在基线、每个治疗周期给药前以及随访(治疗后)就诊时,使用癌症治疗功能评估-黑色素瘤(FACT-M)和EQ-5D-3L问卷对HRQoL进行评估。

结果

与初始分析一致,接受NIVO+RELA治疗的患者HRQoL保持稳定,与接受NIVO治疗的患者相似。从基线开始的平均变化未超过具有临床意义的阈值。HRQoL结果在不同的评估工具和量表/子量表中一致。尽管与NIVO相比,NIVO+RELA组3级或4级TRAEs发生率有所增加,但报告TRAEs使其“相当困扰”或“非常困扰”的患者比例较低,且两组治疗之间相当。

结论

RELATIVITY-047试验结果表明,NIVO+RELA固定剂量组合相对于NIVO在PFS方面具有优势,且患者报告的HRQoL保持稳定,支持将NIVO+RELA作为晚期黑色素瘤患者的一线治疗选择。

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