Abstract 5477
Background
In-transit (IT) melanoma is a form of metastatic disease that is associated with high morbidity and is often refractory to treatment. Intralesional (IAL) IL2 has been increasingly utilized to obtain loco-regional control. This study utilizes a national registry to evaluate response and duration of response of standardized IAL therapy at tertiary centres in 2 provinces.
Methods
Patients (pts) receiving IAL IL2 between 2000 and 2017 were included. Data regarding patient demographics, stage, extent of disease, and all treatments were collected. All pts received a median IL2 dose of 12 million IU given as an IAL injection every 2 to 4 weeks repeated 2 to 8 times to complete a session.
Results
A total of 87 pts aged 21 to 94 (mean: 69 yrs) were included. IT disease was located in the following areas: limbs in 68 pts (79%), head and neck in 13 pts (15%) and trunk in 5 pts (6%). 20% of pts developed IT within 3 months of primary diagnosis, 69% developed IT after 6 months and 11% after 3 years. IT lesions per individual ranged from 1 to 40+; 45% had >10 lesions. Patients had a complete response rate of 32% (28 pts) and a partial response rate of 38% (33 pts). 27 (31%) pts experienced a recurrence after their 1st IL2 session, with a mean of 225 days (median: 204). Of these pts, 15 (56%) pts developed loco-regional recurrences, while 6 (22%) developed distant metastases and 6 (22%) had both distant and loco-regional recurrences. 27 pts (31%) received systemic treatment for metastatic disease. 18 (21%) pts died of disease, while 3% died of other causes while disease was present. 7 (8%) died of other causes with disease status unknown, and 25 (29%) and 34 (39%) are recorded alive with more than a year (1 to 11 yrs) or less than a year follow up, respectively. No grade 3 or 4 toxicity was experienced by pts who received IL2 therapy. On multi-variant analysis, age, extent of disease and prior systemic therapy did not impact overall response (X2 test, p > 0.05).
Conclusions
IAL IL2 appears to be an effective therapeutic option for pts with advanced melanoma and IT disease, with an overall response rate of 70%. With further long-term follow up of these pts, the impact on overall survival can be determined.
Clinical trial identification
Legal entity responsible for the study
Global Melanoma Research Network.
Funding
Global Melanoma Research Network.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.