van Not Olivier J, Wind Thijs T, Ismail Rawa K, Bhattacharya Arkajyoti, Jalving Mathilde, Blank Christian U, Aarts Maureen J B, van den Berkmortel Franchette W P J, Boers-Sonderen Marye J, van den Eertwegh Alfonsus J M, de Groot Jan Willem B, Haanen John B, Kapiteijn Ellen, Bloem Manja, Piersma Djura, van Rijn Rozemarijn S, Stevense-den Boer Marion, van der Veldt Astrid A M, Vreugdenhil Gerard, Wouters Michel W J M, Blokx Willeke A M, Suijkerbuijk Karijn P M, Fehrmann Rudolf S N, Hospers Geke A P
Scientific Bureau, Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands.
Department of Medical Oncology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Cancers (Basel). 2023 May 26;15(11):2922. doi: 10.3390/cancers15112922.
The efficacy of immune checkpoint inhibitors (ICIs) in patients with advanced melanoma that develop brain metastases (BM) remains unpredictable. In this study, we aimed to identify prognostic factors in patients with melanoma BM who are treated with ICIs. Data from advanced melanoma patients with BM treated with ICIs in any line between 2013 and 2020 were obtained from the Dutch Melanoma Treatment Registry. Patients were included from the time of the treatment of BM with ICIs. Survival tree analysis was performed with clinicopathological parameters as potential classifiers and overall survival (OS) as the response variable. In total, 1278 patients were included. Most patients were treated with ipilimumab-nivolumab combination therapy (45%). The survival tree analysis resulted in 31 subgroups. The median OS ranged from 2.7 months to 35.7 months. The strongest clinical parameter associated with survival in advanced melanoma patients with BM was the serum lactate dehydrogenase (LDH) level. Patients with elevated LDH levels and symptomatic BM had the worst prognosis. The clinicopathological classifiers identified in this study can contribute to optimizing clinical studies and can aid doctors in giving an indication of the patients' survival based on their baseline and disease characteristics.
免疫检查点抑制剂（ICI）对发生脑转移（BM）的晚期黑色素瘤患者的疗效仍然难以预测。在本研究中，我们旨在确定接受ICI治疗的黑色素瘤脑转移患者的预后因素。2013年至2020年间接受过任何一线ICI治疗的晚期黑色素瘤脑转移患者的数据来自荷兰黑色素瘤治疗登记处。患者从接受ICI治疗脑转移时开始纳入。以临床病理参数作为潜在分类变量，总生存期（OS）作为反应变量进行生存树分析。总共纳入了1278例患者。大多数患者接受了伊匹木单抗-纳武单抗联合治疗（45%）。生存树分析产生了31个亚组。中位总生存期从2.7个月到35.7个月不等。与晚期黑色素瘤脑转移患者生存相关的最强临床参数是血清乳酸脱氢酶（LDH）水平。LDH水平升高且有症状性脑转移的患者预后最差。本研究中确定的临床病理分类变量有助于优化临床研究，并可帮助医生根据患者的基线和疾病特征对其生存情况做出判断。
