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晚期黑色素瘤患者在免疫检查点抑制下获得完全缓解后的真实世界管理

Real-world management of patients with complete response under immune-checkpoint inhibition for advanced melanoma.

作者信息

Reitmajer Markus, Livingstone Elisabeth, Thoms Kai-Martin, Heppt Markus V, Meiss Frank, Gesierich Anja, Drexler Konstantin, Heinzerling Lucie, Meier Friedegund, Menzer Christian, Schlaak Max, Zimmer Lisa, Forschner Andrea

机构信息

Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany.

Department of Dermatology, University Hospital Essen, Essen, Germany.

出版信息

J Dtsch Dermatol Ges. 2025 Mar;23(3):321-327. doi: 10.1111/ddg.15604. Epub 2025 Jan 2.

Abstract

BACKGROUND

Up to now, the optimal duration of immune checkpoint inhibitors (ICI) has not been evaluated in prospective studies. However, current clinical practice requires decisions to be made regarding the duration of ICI in complete responders.

MATERIAL AND METHODS

A survey was sent to 80 DeCOG skin cancer centers to assess how decisions are made on treatment duration of ICI in melanoma after having reached complete response, and staging intervals after ICI discontinuation. All responses received by March 10, 2024 (51 centers) were included.

RESULTS

The duration of ICI after having achieved complete remission varies between centers from three to 36 months. In total, 66% of the DeCOG centers continue treatment for up to 6 months, after having achieved complete remission (CR) with ICI. In the first year after discontinuation of ICI, most centers perform staging intervals (CT/MRI) every 3 months. More than 60% of centers continue staging at least once per year even in the 4th and 5th year after discontinuation.

CONCLUSIONS

There are significant differences between the centers regarding staging intervals and duration of ICI upon CR. Prospective studies are necessary to determine the optimal time point of ICI discontinuation and follow-up.

摘要

背景

截至目前,免疫检查点抑制剂(ICI)的最佳使用时长尚未在前瞻性研究中得到评估。然而,当前临床实践要求针对完全缓解患者的ICI使用时长做出决策。

材料与方法

向80个DeCOG皮肤癌中心发送了一份调查问卷,以评估在黑色素瘤患者达到完全缓解后,如何确定ICI的治疗时长,以及ICI停药后的分期间隔。纳入了截至2024年3月10日收到的所有回复(51个中心)。

结果

达到完全缓解后ICI的使用时长在各中心之间有所不同,从3个月到36个月不等。总体而言,66%的DeCOG中心在ICI实现完全缓解(CR)后继续治疗长达6个月。在ICI停药后的第一年,大多数中心每3个月进行一次分期检查(CT/MRI)。即使在停药后的第4年和第5年,超过60%的中心仍至少每年继续进行一次分期检查。

结论

各中心在CR后的分期间隔和ICI使用时长方面存在显著差异。有必要开展前瞻性研究以确定ICI停药和随访的最佳时间点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f25/11887019/6af7dbd8f370/DDG-23-321-g001.jpg

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