Abstract 2743
Background
Targeted therapies (TT), combo-immunotherapy (CMI) and mono-immunotherapy (MI) in combination (CRI) or not with radiotherapy are commonly used in patients with melanoma brain metastases (MBMs), but studies that directly compare these strategies are lacking. This meta-analysis aimed to better elucidate their activity and efficacy.
Methods
A systematic search of Medline, Embase and conferences proceedings up to January 2019 was carried out to identify trials investigating combo TT, mono TT, MI, CMI, CRI in MBMs. The outcomes considered were progression free survival (PFS), overall survival (OS) and objective response rate (ORR) evaluated at both intra and extra-cranial sites. Random effects models were used to compare the different therapeutic strategies.
Results
We included 15 trials, which provided 1132 patients for analyses. CMI showed a statistically significant better OS than MI (p = 0.03, p = 0.05, p = 0.03 at 6, 18 and 24 months respectively) and combo TT (p = 0.04, p = 0.03, at 18 and 24 months respectively). CMI showed a statistically significant better PFS compared to combo TT (p < 0.001 at 12 and 18 months), MI (p = 0.02, p < 0.02 and p = 0.05 at 6, 12 and 18 months respectively) and mono TT (p < 0.001 at 6, 12 and 18 months respectively). The intracranial ORR was higher with CMI compared to mono TT (p < 0.001) and MI (p < 0.001), while there was no difference between CMI and combo TT.
Conclusions
This meta-analysis suggests that CMI increases long term PFS and OS compared to MI and combo TT. Combo TT and CMI are associated with a similar intracranial response rate. The role systemic therapy in combination with radiotherapy remains to be better elucidated.
Clinical trial identification
Not applicable
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.
Resources from the same session
3367 - Treatment-Free Survival, With and Without Toxicity, as a Novel Outcome Applied to Immuno-Oncology Agents in Advanced Renal Cell Carcinoma
Presenter: Meredith Regan
Session: Poster Display session 3
Resources:
Abstract
5105 - Fresh blood Immune cell monitoring in patients treated with nivolumab in the GETUG-AFU26 NIVOREN study: association with toxicity and treatment outcome
Presenter: Aude DESNOYER
Session: Poster Display session 3
Resources:
Abstract
1877 - Advanced clear-cell renal cell carcinoma (accRCC): association of microRNAs (miRNAs) with molecular subtypes, mRNA targets and outcome.
Presenter: Annelies Verbiest
Session: Poster Display session 3
Resources:
Abstract
5543 - Prior tyrosine kinase inhibitors (TKI) and antibiotics (ATB) use are associated with distinct gut microbiota ‘guilds’ in renal cell carcinoma (RCC) patients
Presenter: Valerio Iebba
Session: Poster Display session 3
Resources:
Abstract
2689 - mTOR mutations are not associated with shorter PFS and OS in patients treated with mTOR inhibitors
Presenter: Cristina Suarez Rodriguez
Session: Poster Display session 3
Resources:
Abstract
3069 - Efficacy of immune checkpoint inhibitors (ICI) and genomic alterations by body mass index (BMI) in Advanced Renal Cell Carcinoma (RCC)
Presenter: Aly-Khan Lalani
Session: Poster Display session 3
Resources:
Abstract
5089 - Finding the Right Biomarker for Renal Cell Carcinoma (RCC): Nivolumab treatment induces the expression of specific peripheral lymphocyte microRNAs in patients with durable and complete response.
Presenter: Lorena Incorvaia
Session: Poster Display session 3
Resources:
Abstract
2594 - Algorithms derived from quantitative pathology can be a gatekeeper in patient selection for clinical trials in localised clear cell renal cell carcinoma (ccRCC)
Presenter: In Hwa Um
Session: Poster Display session 3
Resources:
Abstract
2566 - High baseline blood volume is an independent favorable prognostic factor for overall and progression-free survival in patients with metastatic renal cell carcinoma
Presenter: Aska Drljevic-nielsen
Session: Poster Display session 3
Resources:
Abstract
2675 - Impact of estimand selection on adjuvant treatment outcomes in renal cell carcinoma (RCC)
Presenter: Daniel George
Session: Poster Display session 3
Resources:
Abstract