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Poster display session

1089 - Validating prognostic models in metastatic uveal melanoma (MUM), an International Rare Cancers Initiative

Date

10 Sep 2017

Session

Poster display session

Presenters

Leila Khoja

Citation

Annals of Oncology (2017) 28 (suppl_5): v428-v448. 10.1093/annonc/mdx377

Authors

L. Khoja1, E. Atenafu2, A.M. Joshua3, I.R.C.I. Ocular Melanoma Group4

Author affiliations

  • 1 Clinical Development Unit, AstraZeneca plc, SG8 6HB - Melbourn/GB
  • 2 Biostatisticis, University of Toronto, Toronto/CA
  • 3 Medical Oncology, Kinghorn Cancer Centre, Sydney/AU
  • 4 Cancer Research Uk, International Rare Cancers Initiative, london/GB
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Resources

Abstract 1089

Background

We validated 2 models (the 7thAmerican joint committee on cancer (AJCC) and the Helsinki university central hospital (HUCH) staging) and 1 nomogram; the Padova-Mayo (PMN), for progression free (PFS) and overall survival (OS) using patient (pt) level data from the PUMMA meta-analysis.

Methods

29 prospective trials’ (1988-2015) pt data was analysed. Models were validated with cox regression analysis for survival in months (m). Concordance index (CCI) was used to test predictive value.

Results

Comparable data was available for 463 pt; see table for variables used in each system. Models were prognostic differentiating into M1a, M1b and M1c groups. Median PFS for AJCC was 4m for M1a, 3 for M1b and 2 for M1c. Median PFS for HUCH was 3.5m for M1a, 2.5 for M1b and 1 for M1c. CCI for PFS using AJCC was 0.69 (SE 0.02, 95%CI 0.65-0.73), for HUCH it was 0.79 (SE 0.02, 95%CI 0.74-0.83). Median OS for AJCC was 15m for M1a, 9 for M1b and 5 for M1c. Median OS for HUCH was 13m for M1a, 6 for M1b and 2 for M1c. CCI for OS for AJCC was 0.69 (SE 0.02, 95%CI 0.65-0.73). For HUCH it was 0.79 (SE 0.02, 95%CI 0.74-0.83). Using ECOG and LDH (available variables used in PMN) median PFS was 4m (95% CI 4-5) for normal LDH and ECOG 0, 7 (3-9) for normal LDH and ECOG > 0, 2.6 (2-3) for elevated LDH and ECOG 0 and 2.5 (2-3) for elevated LDH and ECOG > 0. Corresponding median OS was 17m (95%CI 15-18), 12.7 (95%CI 10-19), 7.4 (95%CI 6.3-8.9) and 5.3 (95%CI 3.8-6.1). CCI were PFS 0.72 (SE 0.02, 95% CI 0.69-0.75), OS 0.73 (SE 0.02, 95% CI 0.7-0.76).Table:

1239P

Variable (n = 463) (n (%), median, range)7thAJCCHUCHPMN
ECOG0296 (64) 156 (34) 11 (2)
1
> 2
Diameter in cm of largest metastasis< 3 cm1.9 (0-2.9)
3-8 cm4.4 (3-8)
> 8 cm10.8 (8.1-22.5)
Diameter of largest liver lesion3.8 (0-22.5)
% liver involvement< 20 20-50 > 50 Missing3 (0-65) 5 (1) 3 (1) 452 (98)
LDH344 (39-8198)
ALP89 (24-1178)
Disease free intervalMissing
OS (%, 95% CI)
M1a689 (83-93)84 (80-88)
1260 (52-68)55 (49-60)
2425 (18-33)22 (18-27)
M1b668 (62-74)48 (39-57)
1238 (31-44)17 (11-24)
2414 (94-19)5 (2-1)
M1c645 (33-57)8 (0-29)
1219 (10-29)0
2478 (27-17)0

Conclusions

Prognostic models in MUM remain imprecise in an externally validated dataset. Further validation is needed to find clinical utility

Clinical trial identification

not applicable

Legal entity responsible for the study

Princess Margaret Cancer Centre

Funding

None

Disclosure

L. Khoja: Employed by Astrazeneca plc. All other authors have declared no conflicts of interest.

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