Impact of prior treatment with immune checkpoint inhibitors on dacarbazine efficacy in metastatic melanoma.
Aged
Aged, 80 and over
Antineoplastic Agents, Alkylating
/ therapeutic use
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Case-Control Studies
Dacarbazine
/ therapeutic use
Disease-Free Survival
Female
Humans
Immune Checkpoint Inhibitors
/ therapeutic use
Male
Melanoma
/ drug therapy
Middle Aged
Retrospective Studies
Treatment Outcome
Journal
British journal of cancer
ISSN: 1532-1827
Titre abrégé: Br J Cancer
Pays: England
ID NLM: 0370635
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
14
03
2021
accepted:
01
07
2021
revised:
07
06
2021
pubmed:
16
7
2021
medline:
18
12
2021
entrez:
15
7
2021
Statut:
ppublish
Résumé
Despite its low efficacy, chemotherapy with dacarbazine remains an option in metastatic melanoma patients after failure of immune checkpoint inhibitors (ICI) ± targeted therapy. Some observations suggested an increased efficacy of chemotherapy in melanoma or lung cancer patients previously treated with ICI; we aimed to evaluate the efficacy of dacarbazine in a controlled-group study of patients pre-treated or not with ICI. We retrospectively collected data from all consecutive patients treated with dacarbazine for advanced cutaneous melanoma without brain metastasis, in our skin cancer centre between June 2006 and September 2019. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall response rates (ORR), overall survival (OS) and safety of dacarbazine. Among 72 patients, 17 (23.6%) received dacarbazine after ICI and 55 (76.3%) without prior ICI. Despite less favourable prognostic factors in patients ICI-pre-treated, median PFS was 4.27 months (range 0.89-43.69) in this group versus 2.04 months (range 1.25-39.25) P = 0.03 in non-ICI-pre-treated patients; ORR were 35.3% and 12.7%, respectively. The median OS and the occurrence of adverse events were similar in both groups. Dacarbazine seems to offer a short-lived benefit in patients with progressive advanced disease despite ICI (±targeted therapy), and could be an alternative before considering best supportive care.
Sections du résumé
BACKGROUND
Despite its low efficacy, chemotherapy with dacarbazine remains an option in metastatic melanoma patients after failure of immune checkpoint inhibitors (ICI) ± targeted therapy. Some observations suggested an increased efficacy of chemotherapy in melanoma or lung cancer patients previously treated with ICI; we aimed to evaluate the efficacy of dacarbazine in a controlled-group study of patients pre-treated or not with ICI.
METHODS
We retrospectively collected data from all consecutive patients treated with dacarbazine for advanced cutaneous melanoma without brain metastasis, in our skin cancer centre between June 2006 and September 2019. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall response rates (ORR), overall survival (OS) and safety of dacarbazine.
RESULTS
Among 72 patients, 17 (23.6%) received dacarbazine after ICI and 55 (76.3%) without prior ICI. Despite less favourable prognostic factors in patients ICI-pre-treated, median PFS was 4.27 months (range 0.89-43.69) in this group versus 2.04 months (range 1.25-39.25) P = 0.03 in non-ICI-pre-treated patients; ORR were 35.3% and 12.7%, respectively. The median OS and the occurrence of adverse events were similar in both groups.
CONCLUSION
Dacarbazine seems to offer a short-lived benefit in patients with progressive advanced disease despite ICI (±targeted therapy), and could be an alternative before considering best supportive care.
Identifiants
pubmed: 34262147
doi: 10.1038/s41416-021-01486-8
pii: 10.1038/s41416-021-01486-8
pmc: PMC8476529
doi:
Substances chimiques
Antineoplastic Agents, Alkylating
0
Immune Checkpoint Inhibitors
0
Dacarbazine
7GR28W0FJI
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
948-954Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Limited.
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