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Poster Display session 3

2928 - Immune checkpoint inhibitors in a cohort of 206 metastatic uveal melanomas patients

Date

30 Sep 2019

Session

Poster Display session 3

Topics

Immunotherapy

Tumour Site

Melanoma

Presenters

Mathilde Saint-Ghislain

Citation

Annals of Oncology (2019) 30 (suppl_5): v533-v563. 10.1093/annonc/mdz255

Authors

M. Saint-Ghislain1, L. Geoffrois2, L. Gastaud3, T. Lesimple4, S. Negrier5, N. Penel6, J. Kurtz7, Y. Le Corre8, S. Gardrat9, R. Barnhill9, N. Cassoux10, P. Mariani11, V. Servois12, S. Piperno-Neumann13, M. Rodrigues1

Author affiliations

  • 1 Medical Oncology, Institut Curie, 75005 - Paris/FR
  • 2 Medical Oncology, Institut de Cancérologie de Lorraine - Alexis Vautrin, 54519 - Vandoeuvre les Nancy/FR
  • 3 Oncology, Centre Antoine Lacassagne, Nice/FR
  • 4 Oncology, Centre Eugene - Marquis, 35042 - Rennes/FR
  • 5 Medical Oncology, Centre Léon Bérard, 69008 - Lyon/FR
  • 6 General Oncology Department, Centre Oscar Lambret, 59020 - Lille/FR
  • 7 Medical Oncology, CHU Hautepierre, 67200 - Strasbourg/FR
  • 8 Dermatology, CHU Angers, Angers/FR
  • 9 Pathology, Institut Curie, Paris/FR
  • 10 Ophtalmology, Institut Curie, Paris/FR
  • 11 Surgical Oncology, Institut Curie, Paris/FR
  • 12 Radiology, Institut Curie, 75005 - Paris/FR
  • 13 Medical Oncology, Institut Curie, Paris/FR

Resources

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Abstract 2928

Background

Uveal melanomas (UM) are BRAF-wild type tumors associated with dismal prognosis for which no systemic therapy is active. We report our experience with immune checkpoint inhibitors (ICI) in metastatic UM patients.

Methods

Ambispective cohort of metastatic UM patients treated with ICI in eight French centers. Response rate, progression-free survival (PFS) and overall survival were retrieved.

Results

206 evaluable patients started their first ICI treatment between December 2012 and January 2019. The population consisted of 98 men and 108 women. Median age was 57.5 yo (19; 82). Seventy-four patients had been enucleated, 131 had received proton beam therapy, one had received brachytherapy. The median time to first metastasis was 29.4 months (0-380.4). ICI were first prescribed in first-line in 68 patients, in second-line in 79 patients, in third-line or more in 80 patients. One hundred forty-four patients received pembrolizumab (63%), 58 nivolumab (25%) and 21 ipilimumab (9%). Metastatic sites at initiation of ICI were liver, lung, skin, and bone for 201, three, one and one patients, respectively. Liver was the sole metastatic site in 201 patients. Patients received a median number of four ICI infusions (1-60+). Treatment was suspended because of immune side effects in 21 patients. Nine objective responses were observed (four complete and five partial responses; 4.4%) including one patient with a hypermutated, MBD4-deficient tumor. Fifty-seven patients showed stable disease as best response (27.7%). Median PFS in the whole cohort was 4.1 months (0; 30.4) in 1st line, 4.9 months (0; 42,6) in 2nd line and 3.1 (1; 17.,3) months in 3rd line. Median PFS was 4.1 months in the ICI-resistant population and 27.4 months in the ICI-sensitive population (log-rank p-test < 0.0001). Median overall survival was 25.9 months in the ICI-resistant population (103/197 deaths) and not reached in the ICI-sensitive population (2/9 deaths; log-rank p-test=0.1).

Conclusions

ICI are associated with a low response rate in UM but with longer PFS and a trend for longer overall survival in ICI-sensitive tumors. Immunotherapies should be investigated in this disease. ICI-sensitive cases are currently being explored to identify biomarkers of response.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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