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Poster Display session 3

4523 - Prognostic Factors for efficacy of Ipilimumab used after AntiPD1 and/or BRAF+MEK inhibitors in Melanoma Patients: an Italian Melanoma Intergroup study


30 Sep 2019


Poster Display session 3



Tumour Site



Riccardo Marconcini


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


R. Marconcini1, A. Nuzzo1, S. Manacorda1, F. de rosa2, P. Fava3, C. Astrua3, L.A. Di Guardo4, A. Raimondi5, S.L. Stucci6, A. Todisco6, A. Cortellini7, M. Bersanelli8, O. Nigro9, M. Palla10, G. Palmieri11, A. Falcone12

Author affiliations

  • 1 U.o. Oncologia Medica, Azienda Ospedaliera Universitaria S.Chiara, 56100 - Pisa/IT
  • 2 Medical Oncology, Istituto Tumori della Romagna I.R.S.T., Meldola/IT
  • 3 Sc Dermatologia, AOU Citta della Salute e della Scienza di torino, 10126 - Torino/IT
  • 4 S.s. Oncologia Medica Melanomi, Dipartimento Oncologia Medica Ed Ematologia, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano (Italy), Milano/IT
  • 5 Medical Oncology Department, Istituto Nazionale dei Tumori di Milano - Fondazione IRCCS, 20133 - Milan/IT
  • 6 Medical Oncology Unit, Department Of Biomedical Sciences And Clinical Oncology, University of Bari, Bari/IT
  • 7 Medical Oncology Dept., Ospedale Civile San Salvatore, 67100 - L'Aquila/IT
  • 8 Medical Oncology Unit, University Hospital of Parma, Parma/IT
  • 9 Medical Oncology, Ospedale di Circolo Fondazione Macchi, 21050 - Varese/IT
  • 10 Melanoma Cancer Immunotherapy And Innovative Therapy Unit, Istituto Nazionale Tumori Fondazione "G Pascale, Napoli/IT
  • 11 Unit Of Cancer Genetics,, Istituto Chimica Biomolecolare, 7100 - Sassari/IT
  • 12 Oncology, Azienda Ospedaliera Universitaria S.Chiara, 56100 - Pisa/IT


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Abstract 4523


Ipilimumab (Ip) is an option in Metastatic Melanoma (MM) patients (pt) in case of disease progression after antiPD1 (AP) treatment and BRAF+MEK inhibitors (BMi) administration (for BRAF mutated melanoma). Clinical trial are evaluating potential Ip-based combinations in 2nd/3rd line setting. Many studies underline the role of some parameters (as LDH, ECOG PS, Neutrophile/Leucocyte ratio) as progostic factors for immunotherapy used in first-line. We evaluate the prognostic role of some relevant clinical or laboratoristic parameters for Ip used in late line after AP, Bmi, in order to define pt that benefit most from Ip monotherapy in this setting.


A retrospective multicenter study was conducted in 8 Italian Oncology Centers, evaluating MM pt treated with Ip after AP and/or BMi. Endpoints were OS and PFS, Kaplan Mayer and Cox regression were applied for survival analysis.


Among 200 pt that received AP or Bmi, 48 were eligible for Ip administration in 2nd/3rd line. Before Ip treatment, ECOG PS was 0 in 21 pt, number of metastatic sites was less then 3 in 14 pt, LDH was within normal range in 19 pt, NLR ratio (= baseline neutrophils/total leukocytes) was less then 0.7 in 28 pt: in univariate analysis, only ECOG PS and NLR resulted significantly associated with better PFS and OS. For pt with ECOG PS 0 or 1 medianPFS was 3.2, 2.3 month respectively (p value 0.0066; HR 0.377 IC95% 0.186-0.762), median OS was 12.1, 4.0 respectively (p value 0.0016 HR 0.287 IC95% 0.132-0.622). For pt with NLR <0,7 or > 0,7 medianPFS was 3.2, 2.0 month respectively (p value 0.002 HR 0.241 IC95% 0.0978-0.593), median OS was 7.63, 2.67 respectively (p value 0.0037 HR 0.251 IC95% 0.0986-0.0637) A score was counted for each pt considering the number of favorable basal factors present (ECOG PS 0, NLR<0.7), from 0 to 2. For pt with SCORE 0,1,2 medianPFS was 4.8, 2.4, 1.4 month respectively (p value 0.0009), median OS was 25.6, 5.8, 1.9 respectively (p value <0.0001).


ECOG PS 0, NLR <0.7, resulted prognostic factors associated with favorable PFS and OS of MM pt treated with Ip after AP or BMi progression. Subgroup with all these factors has a better prognosis. These data can help treatment choice and should be evaluated prospectively.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Italian Melanoma Intergroup.


Has not received any funding.


R. Marconcini: Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Novartis; Honoraria (self), Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: La Roche; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: MSD; Honoraria (self), Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: BMS; Honoraria (self), Advisory / Consultancy: Incyte; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Ipsen. All other authors have declared no conflicts of interest.

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