Abstract 2854
Background
Uveal melanoma (UM) is the most common intraocular malignancy. The disease is clinically and genetically distinct from cutaneous melanoma and shows a high rate of metastatic spread. As randomized clinical trials with immune checkpoint inhibitors (ICI) have not been performed in metastatic UM patients, we analysed the real-world outcomes in a nationwide population-based study.
Methods
Clinical data on patients with UM were extracted from the Danish Metastatic Melanoma database, a nationwide database containing unselected records of all Danish patients with metastatic melanoma. Diagnosis of primary UM was confirmed via the Copenhagen Epidemiological Uveal Melanoma Study database. Survival before (2011-2013, pre-ICI; n = 32) and after (2014-2018, post-ICI; n = 94) the approval of first-line treatment with ICI was analysed.
Results
Treatment and survival data were available from 126 metastatic UM patients. First-line treatment consisted of temozolomide in 28, ipilimumab in 24, pembrolizumab in 43 and the combination ipilimumab/nivolumab in 19 patients. Twelve patients did not receive any systemic treatment. No complete responses were observed. A partial response was observed in 7.0% of patients treated with pembrolizumab and in 21.1% treated with ipilimumab plus nivolumab. Median progression-free survival was 2.5 months for patients treated in the pre-ICI era compared to 3.7 months in the post-ICI era (HR 0.37; 95 CI 0.24-0.59; p < 0.01). The estimated 1-year overall survival rate increased from 25.0% to 41.9% and the median overall survival improved from 7.8 months to 10.0 months, respectively (HR 0.52; 95 CI 0.34-0.80; p < 0.01).
Conclusions
The introduction of ICI as first-line treatment appears to have significantly improved the real-world survival of patients with metastatic UM, despite relatively low response rates. With the lack of therapies proven effective in randomized trials, these data support the current treatment with ICI in patients with metastatic UM.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Danish Melanoma Oncology Group.
Funding
The Danish Metastatic Melanoma database is supported by BMS, Roche, MSD and Novartis. K.F. Bol has received funding from the European Union (Marie Sklodowska-Curie grant).
Disclosure
K.F. Bol: Travel / Accommodation / Expenses: Roche. E. Ellebaek: Honoraria (self): BMS; Honoraria (self): Roche; Honoraria (self): Kyowa Kirin. M. Donia: Honoraria (self): BMS; Honoraria (self): Sanofi-Genzyme; Honoraria (self): MSD; Honoraria (self): AstraZeneca; Honoraria (self): Roche; Honoraria (self): Novartis. H. Schmidt: Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): MSD; Honoraria (self), Advisory / Consultancy: Incyte; Honoraria (self), Advisory / Consultancy: BMS; Honoraria (self), Advisory / Consultancy: Novartis. L. Bastholt: Advisory / Consultancy: MSD; Advisory / Consultancy: Incyte; Advisory / Consultancy: BMS; Advisory / Consultancy: Roche; Advisory / Consultancy: Eisai; Advisory / Consultancy: Novartis; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Bayer; Advisory / Consultancy: Amgen; Advisory / Consultancy: Swedish Orphan. I. Svane: Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Roche; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Novartis; Honoraria (self), Advisory / Consultancy: MSD; Honoraria (self), Advisory / Consultancy: Celgene; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Incyte; Honoraria (self), Advisory / Consultancy: TILT Bio; Honoraria (self), Advisory / Consultancy: Pfizer; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): BMS; Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy, Shareholder / Stockholder / Stock options: IO Biotech. All other authors have declared no conflicts of interest.
Resources from the same session
4758 - A Phase I Study of the CDK4/6 Inhibitor, Palbociclib in combination with Cetuximab and Intensity Modulated Radiation Therapy (IMRT) for Locally Advanced Squamous Cell Carcinoma of the Head and Neck (SCCHN); A Result of Dose Escalation Cohort
Presenter: Nuttapong Ngamphaiboon
Session: Poster Display session 3
Resources:
Abstract
2607 - Single cycle induction treatment with Cisplatin/Docetaxel plus Durvalumab/Tremelimumab in Stage III-IVB head and neck squamous cell cancer (CheckRad-CD8 trial)
Presenter: Markus Hecht
Session: Poster Display session 3
Resources:
Abstract
1388 - Radiotherapy plus cisplatin (CDDP) or cetuximab (C225) in human papilloma-virus (HPV)-associated oropharyngeal cancer (OPC)? A dillema finally resolved. An updated meta-analysis.
Presenter: Petar Suton
Session: Poster Display session 3
Resources:
Abstract
1478 - Treatment outcomes of head and neck cancer patients 70 years and older receiving different chemo-radiation combinations.
Presenter: Majd Issa
Session: Poster Display session 3
Resources:
Abstract
3985 - Brachytherapy and non-cancer mortality in patients with oral cavity and oropharynx SCCs
Presenter: Jovian Yu
Session: Poster Display session 3
Resources:
Abstract
4036 - Final results of a phase II study of induction chemotherapy (CT) with paclitaxel (PTX) and panitumumab (P) followed by radiotherapy (RT) and P in patients (pts) with locally advanced head and neck cancer (LAHNC) no candidates to platinum: study PANTERA
Presenter: Javier Martinez Trufero
Session: Poster Display session 3
Resources:
Abstract
4779 - Window of Opportunity for Durvalumab (MEDI4736) plus Metformin Trial in Squamous Cell Carcinoma of the Head and Neck (SCCHN): interim safety analysis
Presenter: Tony Richa
Session: Poster Display session 3
Resources:
Abstract
2757 - Severe Oral Mucositis (SOM) Mitigation by Genetically Modified Lactococcus Lactis Bacteria (LLB) Producing Human Trefoil Factor 1 (hTFF1; AG013) in Patients Being Treated With Concomitant Chemoradiation (CRT) for Oral and Oropharyngeal Cancers (OCOPC)
Presenter: Suraj Singh
Session: Poster Display session 3
Resources:
Abstract
5559 - Transcriptome signatures of treatment responses in a preoperative window of opportunity trial of nivolumab and tadalafil in resectable squamous cell carcinoma of the head and neck
Presenter: Sanket Shukla
Session: Poster Display session 3
Resources:
Abstract
3263 - Risk and Impact of Renal Impairment of Locally Advanced Head and Neck Squamous Cell Carcinoma Patients Who Received Chemoradiotherapy with Cisplatin
Presenter: Thana Patimarattananan
Session: Poster Display session 3
Resources:
Abstract