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Poster Discussion session - Melanoma and other skin tumours

1733 - Concomitant radiotherapy in melanoma brain metastases using the propensity score matching within the French cohort, MelBase.

Date

20 Oct 2018

Session

Poster Discussion session - Melanoma and other skin tumours

Presenters

Clara Allayous

Citation

Annals of Oncology (2018) 29 (suppl_8): viii442-viii466. 10.1093/annonc/mdy289

Authors

C. Allayous1, B. Oriano2, S. Dalle3, L. Mortier4, M. Leccia5, B. Guillot6, G. Jeudy7, C. Dutriaux8, J. Lacour9, P. Saiag10, F. Brunet-Possenti11, J. De Quatrebarbes12, P. Stoebner13, D. Legoupil14, M. Beylot-Barry15, T. Lesimple16, F. Aubin17, A. Ballon1, R. Porcher2, C. Lebbe1

Author affiliations

  • 1 Dermatology, AP-HP, Saint-Louis hospital, 75010 - Paris/FR
  • 2 Biostatistics, AP-HP, Hotel-Dieu hospital, 75004 - Paris/FR
  • 3 Dermatology, Lyon Sud hospital, 69495 - Pierre Bénite/FR
  • 4 Dermatology, Lille hospital, 59037 - Lille/FR
  • 5 Dermatology, Grenoble hospital, 38043 - La Tronche/FR
  • 6 Dermatology, Montpellier hospital, 34090 - Montpellier/FR
  • 7 Department Of Dermatology, Dijon university hospital, Dijon/FR
  • 8 Dermatology, Bordeaux St. André hospital, 33000 - Bordeaux/FR
  • 9 Dermatology, Nice hospital, 06200 - Nice/FR
  • 10 Dermatology, AP-HP Ambroise Paré hospital, 92100 - Boulogne-Billancourt/FR
  • 11 Dermatology, AP-HP Bichat hospital, 75877 - Paris/FR
  • 12 Dermatology, Annecy Genevois hospital, 74370 - Annecy/FR
  • 13 Dermatology, Nimes hospital, 30029 - Nimes/FR
  • 14 Dermatology, Brest hospital, 29609 - Brest/FR
  • 15 Dermatology, Bordeaux Saint-André hospital, 33000 - Bordeaux/FR
  • 16 Department Of Medical Oncology, Eugene Marquis Center, Rennes/FR
  • 17 Dermatology, Besançon hospital, 25030 - Besançon/FR
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Resources

Abstract 1733

Background

Melanoma brain metastases (MBM) are historically associated with poor prognosis. Radiotherapy (RT), mainly stereotactic, improves local control in pauci-metastatic disease. Targeted therapies (TT) and immunotherapies were recently allowed for a significant overall intracranial response that remains inferior and less durable than in extracranial metastases. This study investigates the role of concomitant RT (cRT) in real-life MBM patients (pts).

Methods

MelBase is a French multicentric biobank prospectively enrolling unresectable stage III or IV melanoma ( > 1400 pts) since Dec. 2013. Data from 262 MBM pts were collected (Dec. 2017) and compared between cRT (68% stereotactic) and no cRT (demography, treatment, overall survival (OS), progression-free survival (PFS), safety). We used inverse propensity score weighting (IPW) to correct for indication bias.

Results

Overall, 93 pts were treated by cRT (g1), 169 were not (g2). Mean age in g1 was 58 years, 95% of g1 pts were PS 0-1, 42% had elevated LDH, 29% had less than 3 MBM, 14% were leptomeningeal, 58% were asymptomatic; 31% received TT, 56% anti-PD1, 13% ipilimumab. Mean age in g2 was 61 years, 85% of g2 pts were PS 0-1, 37% had elevated LDH, 47% had less than 3 MBM, 7% were leptomeningeal, 60% were asymptomatic; 40% received TT, 23% anti-PD1, 21% ipilimumab. Median FU was 6.9 months (3.3-15.9). Median OS was respectively 16.8 (g1; 95%CI: 11.8-27.9) and 6.9 (g2; 95%CI: 5.4-9.4) months; median PFS was respectively 3.9 (g1; 95%CI: 3.3-5.2) and 3.6 (g2; 95%CI: 3.2-4.9) months with a low toxicity profile (g1: 20% grade 3-4; g2: 23% grade 3-4). IPW was successful in balancing prognostic variables between g1 and g2. In the weighted sample, cRT prolonged OS (HR 0.62; 95%CI: 0.44-0.79; p = 0.008).

Conclusions

To our knowledge, this study is the first to confirm the impact on survival of cRT in combination with systemic therapies in real-life MBM pts using the propensity score matching to mimic particular characteristics of a randomized trial and reduce or eliminate the effects of confounding in observational data. This method will be applied to take into account the effect of each systemic therapy associated with cRT.

Clinical trial identification

Legal entity responsible for the study

AP-HP DRCI.

Funding

French National Cancer Institute (INCa), BMS, MSD, Novartis, Roche.

Editorial Acknowledgement

Disclosure

C. Allayous: Meeting, travels, accomodations: Amgen, BMS, Roche. S. Dalle: Research funding: Roche, BMS; Travel, accomodations, expenses: BMS, MSD. L. Mortier: Travel, accomodations, expenses: Roche, BMS, Novartis. G. Jeudy: Consulting or advisory role: Roche, MSD. C. Dutriaux: Consulting or advisory role: Novartis, Roche, BMS, MSD. J-P. Lacour: Honoraria: BMS; Research funding: Roche, Novartis, BMS, MSD. P. Saiag: Honoraria: Roche, Novartis, Array BioPharma, Pierre Fabre, BMS, MSD; Consulting or advisory role: Roche, Novartis, Array BioPharma, Pierre Fabre, BMS, MSD; Research funding: Roche; Travel, accomodations, expenses: Roche, Novartis, BMS, MSD. J. De Quatrebarbes: Consulting or advisory role: BMS, Janssen; Travel, accomodations, expenses: Abbvie, BMS, MSD, Janssen. P-E. Stoebner: Travel, accomodations, expenses: Novartis, Janssen. D. Legoupil: Honoraria: BMS, Consulting or advisory role: BMS; Travel, accomodations, expenses: BMS. M. Beylot-Barry: Consulting or advisory role: Roche, BMS, MSD; Speakers' bureau: Novartis; Research funding: Roche; Travel, accomodations, expenses: Roche. T. Lesimple: Consulting or advisory role: Roche, Novartis, Incyte, MSD; Research funding: Roche; Travel, accomodations, expenses: Roche, BMS, MSD. F. Aubin: Consulting or advisory role: Roche, Novartis, Celgene, BMS, MSD; Travel, accomodations, expenses: Novartis, Abbvie. C. Lebbe: Honoraria: Roche, Novartis, Amgen, BMS, MSD; Consulting or advisory role: Roche, Novartis, Amgen, BMS, MSD; Speakers' bureau: Roche, Amgen, Novartis, BMS; Research funding: Roche, BMS; Travel, accomodations, expenses: Roche, Amgen, BMS. All other authors have declared no conflicts of interest.

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