Abstract 1618
Background
Anti-PD-1 antibodies have changed the treatment landscape for patients with metastatic melanoma. Two of these antibodies, pembrolizumab (P) and nivolumab (N), are currently FDA approved in the frontline setting for these patients. The efficacy of these drugs has not been directly compared; thus we aimed to compare the overall survival for patients with metastatic melanoma treated with either front line P or N in routine clinical practice.
Methods
This study included patients with advanced melanoma treated with frontline P or N using the U.S. nationwide Flatiron Health electronic health record (EHR)-derived database. Overall survival (OS) from the start of frontline therapy was estimated for each treatment group using Kaplan-Meier curves with a log-rank test. OS comparative-effectiveness was estimated using a propensity score-matched Cox regression model to reduce bias for pairs of P (n = 371) and N treated subjects (n = 371). Propensity scores were generated using age, gender, ECOG, LDH (elevated or not), BRAF (mutated or not), KIT (mutated or not), NRAS (mutated or not), PD-L1 expression (0% or greater), BMI and primary site.
Results
From a total of 7650 melanoma patients, 888 had advanced disease treated with frontline P (n = 486) or N (n = 402). 58% of N treated patients received flat 240 mg q2 week dosing and 38% of P treated patients received flat 200 mg q3 week dosing. Median OS for patients treated with P was 22.6 months(m) and was 23.9 m for those treated with N (p = 0.91). In the propensity score matched analysis (n = 742), there was no difference in survival between patients treated with P or N (HR 1.10; 95% CI 0.87-1.39).
Conclusions
In our retrospective real world analysis of patients with advanced melanoma, no statistical difference in OS was noted between patients treated with frontline P compared to N. This supports the current practice of choosing either P or N based on patient and provider preference.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Huntsman Cancer Institute.
Funding
Has not received any funding.
Disclosure
K.F. Grossmann: Advisory / Consultancy: Array BioPharma; Advisory / Consultancy: Bristol-Myers Squibb; Advisory / Consultancy: Genentech; Advisory / Consultancy: Novartis; Advisory / Consultancy: Castle Biosciences. S. Patel: Research grant / Funding (institution): Merck. All other authors have declared no conflicts of interest.
Resources from the same session
3839 - Fenofibrate impairs pro-tumorigenic potential of cancer stem cell-like cells within drug-resistant prostate cancer cell populations.
Presenter: Tomasz Wróbel
Session: Poster Display session 3
Resources:
Abstract
3842 - Effect of docetaxel-resistance on the reactivity of prostate cancer cells to metformin
Presenter: Jessica Catapano
Session: Poster Display session 3
Resources:
Abstract
5198 - Cell plasticity and taxanes resistance in metastatic prostate cancer: ESRP1 as a predictive biomarker of taxane response
Presenter: Natalia Jimenez
Session: Poster Display session 3
Resources:
Abstract
2981 - Effect of Selumetinib plus AZD8186 treatment on Cabazitaxel sensitivity in docetaxel-acquired resistant metastatic prostate cancer cell lines
Presenter: Vicenc Ruiz de Porras
Session: Poster Display session 3
Resources:
Abstract
2779 - Anti-tumor activity of cediranib, a pan-inhibitor of vascular endothelial growth factor receptors, in pancreatic ductal adenocarcinoma cells
Presenter: Majid Momeny
Session: Poster Display session 3
Resources:
Abstract
1782 - The molecular mechanisms of EpCAM in regulating tumor progression and development of anti-EpCAM antibodies for colon cancer diagnosis and therapy
Presenter: Han-chung Wu
Session: Poster Display session 3
Resources:
Abstract
1322 - Detection of microRNAs as biomarker for anti-EGFR antibody resistance in colon cancer patients
Presenter: Jens Hahne
Session: Poster Display session 3
Resources:
Abstract
1579 - Serum exosomal microRNA-199b-5p as a novel circulating biomarker to predict response of preoperative chemoradiotherapy for locally advanced rectal cancer
Presenter: Dong Won Baek
Session: Poster Display session 3
Resources:
Abstract
1761 - Live biobank of patient-derived organoids from Thai colorectal cancer patients enables clinical outcome prediction
Presenter: Pariyada Tanjak
Session: Poster Display session 3
Resources:
Abstract
3542 - The biological implications of PDCD6 dysregulation in colorectal cancer
Presenter: Romina Briffa
Session: Poster Display session 3
Resources:
Abstract