Clinical and laboratory markers as predictors of Time to Treatment Failure (TTF) and Overall Survival (OS) in patients (pts) with mucosal melanoma...

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Melanoma
Personalised/Precision Medicine
Presenter Francisco Javier Ros Montañá
Citation Annals of Oncology (2018) 29 (suppl_9): ix105-ix108. 10.1093/annonc/mdy439
Authors F.J. Ros Montañá1, I. Baraibar Argota2, C. Ortiz Velez1, J.F. Grau Béjar3, G. Villacampa4, V. Garcia-Patos5, D. Bodet5, C. Fernandez-Pulido5, R. Dienstmann4, E. Muñoz-Couselo3
  • 1Medical Oncology, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 2Medical Oncology, Clinica Universitaria de Navarra, 31008 - Pamplona/ES
  • 3Medical Oncology Department, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 4Oncology Data Science, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 5Dermatology Department, Vall d'Hebron University Hospital, 08035 - Barcelona/ES

Abstract

Background

MM is a clinically and molecularly unique subtype of a melanoma with no clear effective treatment despite the advances in cutaneous melanoma (CM) management. Our objective is to describe clinical characteristics and to assess laboratory markers as predictors of patient outcome under standard therapies.

Methods

We prospectively collect clinical and laboratory data on melanoma pts treated at Vall d´Hebron Hospital (Spain) and Clínica Universitaria de Navarra (Spain). This study is a retrospective and multicentre analysis on clinical outcomes of 33 MM pts undergoing treatment with immunotherapies (IT), chemotherapies (CT) and target therapies (TT) according to baseline LDH and neutrophil/lymphocyte (NLR).

Results

Half of our pts were female, median age was 65 years and all presented with metastatic disease. 3 pts (9%) had BRAFV600 mutation. Mucosal sites were head and neck (n = 2, 28%), vulva (n = 8, 25%) and ano-rectal (n = 15, 46%). In total 20 pts (60%) received 2 therapies and 12 pts (36%) received 3 regimens. From 65 therapies, 41 were IT (63%), 19 (29%) other treatments and 5 TT (7.7%). Clinical benefit rate (defined as complete, partial response or stable disease for 4 months) was higher with IT (53%) and TT (20%) as compare to CT (0%, p < 0.01). Overall, median TTF was 3 months (CI95% 2-3.7) without significant differences between IT, CT and TT (p > 0.5 all comparisons). However, antiPD1/L1 IT as a single agents (n = 17) or in combination (n = 13) had improved TTF (3.9 months, 3-5.6+) as compared to anti-CTLA4 IT (n = 11, 1.4 months, 1.1-3.5+, HR = 0.61, p = 0.24). NLR and LDH levels as continuous variables were associated with TTF (HR = 1.13, p = 0.01 and HR = 1.01, p = 0.02, respectively). With median follow-up of 11 months, median OS was 18.7 months (8-NA). In univariate model, pts with nodal involvement were linked to better OS (HR = 0.26, p < 0.01).

Conclusions

IT seemed to have greater efficacy in MM than conventional treatments. Clinical and laboratory markers predicting outcome in CM appear to be valid in MM. Of note, in our cohort 3 patients had BRAF mutation. Further studies are needed to a better characterization of MM and to find biomarkers that allow us to find more accurate treatments.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Vall dˈHebron Institute of Oncology.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.