Abstract 4278
Background
Specific anatomical locations of melanoma mets (MM) influence OS in pts treated with anti-PD-1 based immunotherapy (IT), but little is known about anatomical distribution of mets within a patient (patterns of MM). We investigated the clinical factors and OS associated with the patterns of MM.
Methods
Demographics, disease characteristics and patient outcomes were examined from MM pts. Univariate and multivariable (MVA) logistic regression was used to identify factors associated with patterns of MM. Cox proportional hazards method for OS analysis.
Results
6031 MM pts were studied; median age of 61yo, 66% male, 32% elevated LDH, 74% stage IV M1c/d. 17% had systemic treatment; IT (61%), targeted therapy (32%) and chemotherapy (7%) 1st line. Median FU was 57.5 months (mos) and the median OS (mOS) was 9.4 mos (untreated: 7.5 mos; treated: 39.4 mos). In MVA performed on untreated pts, elevated LDH (HR 1.5) and presence of brain (HR 1.5), liver (HR 1.8) and bone (HR 1.5) mets were associated with shorter OS; while gastrointestinal (GI) mets (HR 0.8) were associated with longer OS. Similar results were found for treated pts; but male pts had shorter OS (HR 1.3) and GI mets did not affect OS. Within all pts, mOS for pts with vs without brain mets was 8 vs 10 mos (p < 0.01), respectively; and mOS for pts with vs without liver mets was 7 vs 11 mos (p < 0.01), respectively. In untreated pts, brain mets were associated with adrenal mets, but not liver, GI, bone or subcutaneous (subcut); while in treated pts brain mets were associated with adrenal and subcut mets. Liver mets occurred frequently with bone, adrenal and spleen mets, and less frequently with brain, GI and subcut mets in untreated pts; while they were associated with bone and spleen mets in treated pts. Untreated pts with brain, liver or bone mets had longer mOS in the presence of GI mets (7 vs 11; 6 vs 8; 7 vs 11mos, respectively), while GI mets did not affect OS in treated pts. Treated pts with liver mets have shorter OS (22 mos) if bone (18 mos), adrenal (14 mos) or spleen (18 mos) mets are present, but this was not seen in untreated pts.
Conclusions
Both treated and untreated pts have distinct patterns of MM and survival. These data may help defining prognosis and provides insight to further studies on the biology of mets.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Melanoma Institute Australia.
Funding
Has not received any funding.
Disclosure
M.S. Carlino: Advisory / Consultancy: MSD; Advisory / Consultancy: Novartis; Advisory / Consultancy: BMS; Advisory / Consultancy: Amgen; Advisory / Consultancy: Pierre Fabre. A.M. Menzies: Advisory / Consultancy: BMS; Advisory / Consultancy: MSD; Speaker Bureau / Expert testimony: Novartis; Advisory / Consultancy: Roche; Advisory / Consultancy: Pierre Fabre. G.V. Long: Advisory / Consultancy: Amgen; Advisory / Consultancy: Mass-Array; Advisory / Consultancy: BMS; Advisory / Consultancy: Merck MSD; Advisory / Consultancy: Novartis; Advisory / Consultancy: Pierre Fabre; Advisory / Consultancy: Roche; Advisory / Consultancy: Aduro. All other authors have declared no conflicts of interest.
Resources from the same session
3628 - Predictive model for survival in advanced non-small-cell lung cancer (NSCLC) treated with frontline pembrolizumab
Presenter: Xabier Mielgo Rubio
Session: Poster Display session 3
Resources:
Abstract
5705 - External validation and longitudinal extension of the LIPI (Lung Immune Prognostic Index) for immunotherapy outcomes in advanced non-small cell lung cancer.
Presenter: Jakob Riedl
Session: Poster Display session 3
Resources:
Abstract
5758 - Changes of TCR Repertoire in Metastatic Renal Cell Carcinoma and Metastatic Melanoma Patients Treated with Nivolumab
Presenter: Martin Klabusay
Session: Poster Display session 3
Resources:
Abstract
1743 - Expression of MHC class I, HLA-A and HLA-B identifies immune activated breast tumors with favorable outcome
Presenter: María Del Mar Noblejas López
Session: Poster Display session 3
Resources:
Abstract
2219 - Prognostic Significance of Tumor Tissue NeuGcGM3 Ganglioside Expression and Predictive Value of Circulating Tumor Cell Count Monitoring in Patients Receiving Racotumomab Immunotherapy
Presenter: Necdet Üskent
Session: Poster Display session 3
Resources:
Abstract
2996 - Evolution of Myeloid-Derived Suppressor Cells and Objective Response Rate in Relapsed/Refractory Diffuse Large B Cell Lymphoma (R/R DLBCL) patients after receiving immunotherapy
Presenter: Carlos Jiménez Cortegana
Session: Poster Display session 3
Resources:
Abstract
2110 - A Phase Ia/Ib trial of the anti-programmed death-ligand 1 (PD-L1) human monoclonal antibody (mAb), CS1001, in patients (pts) with advanced solid tumors or lymphomas
Presenter: Lin Shen
Session: Poster Display session 3
Resources:
Abstract
3515 - Results from a randomised Phase 1/2 trial evaluating the safety and antitumour activity of anti-PD-1 (MEDI0680)/anti-PD-L1 (durvalumab) vs anti-PD-1 (nivolumab) alone in metastatic clear cell renal cell carcinoma (ccRCC)
Presenter: Martin Voss
Session: Poster Display session 3
Resources:
Abstract
3566 - Pembrolizumab in Advanced Rare Cancers
Presenter: Aung Naing
Session: Poster Display session 3
Resources:
Abstract
3567 - High clinical benefit rates of pembrolizumab in very rare sarcoma histotypes: first results of the AcSé Pembrolizumab study
Presenter: Jean-Yves Blay
Session: Poster Display session 3
Resources:
Abstract