Abstract 4437
Background
Long-term survival for patients with metastatic melanoma (MM) was very rare until the advent of targeted and checkpoint inhibitor therapy. Today clinical trial data provide evidence of encouraging 3-year and even 5-year survival rates, while real-world data are lacking.
Methods
Patient and disease characteristics were collected among MM patients treated in a reference oncology center since 2012 with targeted and/or checkpoint inhibitor agents. We defined long-term survivors as patients with survival >2years from MM diagnosis; biological material was collected for genomic analyses.
Results
From 130 MM patients treated with BRAF/MEK inhibitors and/or anti-CTLA4, anti-PD1 agents in any line, 25 long-term survivors were identified (19,2%), 15 men/ 10 women. Long-term survival was characterized by good prognosis features at initial diagnosis: median PS 0, normal LDH (60%), low disease burden (≤3 metastatic sites, 88%), median Distant Metastasis Free Interval (DMFI) 3 years (range 0-23+ years), 16/25 BRAF mutant MM. All long-term survivors had achieved an objective response (complete/partial) to targeted or immuno- therapy. Objective response was associated with long-term survival regardless of treatment line. Complete responses to targeted or immunotherapy are still ongoing (2 to immunotherapy >3 years, 2 to BRAF/MEKi >5 years). Most patients are alive today (21/25, 84%): 9 patients (36%) survive >5 years from MM diagnosis, with 8 of them (32%) surviving >5 years from new therapy initiation (targeted or immuno). The majority of patients (22/25, 88%) survive >3 years from initial MM diagnosis and 76% survive >3 years from therapy initiation (targeted or immuno-), suggesting that the long-term survival benefit is due to the new therapy. Genomic analysis will complement the clinical characteristics of long-term survival.
Conclusions
A significant number of patients with MM treated in a reference center achieved long-term survival with targeted or immuno-therapy. The specific clinical and genomic characteristics of these long-term survivors can improve our understanding of the biological behaviour of the disease but also assist the optimal choice and use of new therapies.
Clinical trial identification
Legal entity responsible for the study
Oncology Department, Metropolitan Hospital, Athens.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.