Abstract 1044P
Background
Targeted (TT) and immunotherapies (IT) significantly improved the outcome of stage IV melanoma patients (pts). However, data on the optimal therapy sequence are missing for patients with BRAFV600 mutated melanoma.
Methods
In this retrospective study, we analyze stage IV melanoma patients who were treated at the Center for Dermato-Oncology of the Tuebingen University between January 2011 and December 2018. Patients received IT 1stline (1L) and 2nd line (2L) (IT-IT); IT 1L and TT 2L (IT-TT); TT 1L and IT 2L (TT-IT) and TT 1L and 2L (TT-TT). The date of data cut-off analysis was October 2020. Follow-up time (FUP) was the time between stage IV diagnosis and death or last contact. We performed descriptive analyses of pts characteristics for the subgroups mentioned and overall survival (OS) analysis. Data on best overall response, progression-free survival, and other subgroup analyses will also be presented.
Results
We included 1046 stage IV melanoma pts with a median FUP of 29 months (M) [IQR: 14M:67M]. 396 patients of the entire cohort (n=1046) have received at least two lines of systemic therapy. The number of pts treated with each therapy sequence is as follows: IT-IT 91 pts, TT-IT 83 pts, IT-TT 41 pts, and TT-TT 33 pts; 148 pts received other combinations of 1L and 2L. When comparing the subgroup of patients with BRAFV600 mutated melanoma who received sequential therapy with IT-TT or TT-IT (Pearson's chi-squared test) there were no statistically significant differences regarding sex, age, presence of elevated LDH, or elevated protein S100 at the time of stage IV diagnosis. The median OS (mOS) and the 5-years (5-y) OS rate for the whole collective (n=1046) was 19M and 29%, respectively. For pts receiving at least two lines of systemic therapy (n=396), the mOS and 5y OS rate were 21M and 25%, respectively. For the 4 therapy sequences, the mOS and 5y OS rate were: IT-IT 36M and 34%; TT-IT 18M and 16%; IT-TT 17M and 32%; TT-TT 32M and 31%, respectively. There was no statistically significant difference in mOS between the 4 sequences (p=0.084) or the IT-TT and TT-IT sequences (p=0.677).
Conclusions
2L therapies seem to have a modest impact on OS. There was no significant difference in terms of OS between the four sequences.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
German Central Malignant Melanoma Registry.
Disclosure
T.M.S. Amaral: Financial Interests, Personal, Invited Speaker: CeCaVa; Financial Interests, Personal, Invited Speaker: BMS; Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Personal, Invited Speaker: Pierre Fabre; Financial Interests, Institutional, Funding: Novartis; Financial Interests, Institutional, Funding: Neracare; Financial Interests, Institutional, Funding: Sanofi; Financial Interests, Institutional, Research Grant: Novartis; Financial Interests, Institutional, Funding: Skyline-Dx; Non-Financial Interests, Member: Portuguese Society for Medical Oncology; Non-Financial Interests, Member: Portuguese Society of Medical Oncology - Young Oncologists Group. H. Niessner: Financial Interests, Institutional, Research Grant: Novartis. T. Sinnberg: Financial Interests, Institutional, Research Grant: Novartis. I. Thomas: Financial Interests, Personal, Other, Travel support, congress registration: Roche, AbbVie, Novartis. A. Forschner: Financial Interests, Personal, Advisory Role: Roche, Novartis, MSD, BMS, Pierre-Fabre; Financial Interests, Personal, Other, Travel support: Roche, Novartis, BMS, Pierre-Fabre; Financial Interests, Personal, Invited Speaker: Roche, Novartis, BMS, MSD, CeGaT; Financial Interests, Institutional, Research Grant: BMS Stiftung Immunonkologie. U. Leiter: Financial Interests, Institutional, Funding: MSD Sharp & Dohme GmbH, Haar, Germany; Financial Interests, Personal, Invited Speaker: Sanofi, Sun Pharma, Novartis; Financial Interests, Personal, Advisory Board: MSD, Novartis, Roche, Almirall Hermal, Sun Pharma, Sanofi. L. Flatz: Financial Interests, , Advisory Role: Novartis, Sanofi and Bristol-Myers Squibb; Financial Interests, , Research Grant: Swiss National Science Foundation, Swiss Cancer League, Hookipa Pharma, and Novartis Foundation . T. Eigentler: Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Principal Investigator: Roche; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Principal Investigator: Novartis; Financial Interests, Personal, Advisory Board: Philogen; Financial Interests, Personal, Principal Investigator: Philogen; Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Principal Investigator: BMS; Financial Interests, Personal, Funding: BMS; Financial Interests, Personal, Advisory Board: Pierre Fabre; Financial Interests, Personal, Speaker’s Bureau: Amirall. C. Garbe: Financial Interests, Personal, Advisory Board: Pierre Fabre; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal and Institutional, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal and Institutional, Advisory Board: Neracare; Financial Interests, Personal and Institutional, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: Philogen; Financial Interests, Personal and Institutional, Advisory Board: Roche; Financial Interests, Personal and Institutional, Advisory Board: Sanofi. All other authors have declared no conflicts of interest.