Abstract 1116P
Background
Clinical trials have demonstrated improved overall survival (OS) and progression-free survival (PFS) associated with pembro for treatment of advanced melanoma. As real-world data availability differs from trials, this study assessed OS, as well as proxies for PFS based on provider-documented response assessments.
Methods
Adult patients (pts) with advanced melanoma who initiated pembro between 01 January 2014 – 31 December 2016 were followed through 01 January 2020 (18.2 months median follow-up). Study data were sourced through electronic health records. Kaplan-Meier (KM) methods were used to assess: OS, time to treatment discontinuation (TTD), time to next treatment (TTNT), time to physician-assessed tumor progression (rwTTP) and physician-assessed PFS (rwPFS) from initiation of pembro, with log-rank tests to assess differences by line of therapy. Multivariable Cox regression models were constructed to evaluate independent risk factors for OS and rwPFS.
Results
303 pts were included (median age 67 years, 94.4% Caucasian, 63.0% male): 119, 131 and 53 received pembro in the first- (1L), second- (2L) and third-line or beyond (3L+) setting, respectively. The table presents the KM estimates (in months) of clinical outcomes. Increased age and worsening performance status were associated with an increased risk of all-cause death, while elevated lactate dehydrogenase, brain metastases and 3L+ pembro were associated with both an increased risk of all-cause death as well as progression or death.
Conclusions
Favorable clinical outcomes were associated with pembro, especially in the 1L setting. Similar median durations of TTD and rwPFS were observed, with markedly higher estimates observed for TTNT and rwTTP. Table: 1116P
| Endpoint (in months; 95% confidence interval) | Overall | 1L | 2L | 3L+ | Log-rank p-value |
| OS | 29.3(20.3,49.7) | 42.8(24.8,NR) | 30.0(14.9,54.5) | 13.8(4.8,25.7) | 0.0080 |
| TTD | 4.8(3.6,5.3) | 5.1(4.0,8.1) | 4.8(3.5,6.0) | 2.8(1.4,6.2) | 0.7118 |
| TTNT | 10.6(7.3,18.8) | 19.5(8.5,27.3) | 8.9(5.6,18.8) | 6.5(3.7,19.0) | 0.2615 |
| rwTTP | 11.2(6.7,20.7) | 18.2(8.5,43.2) | 13.1(4.4,37.1) | 3.4(2.1,16.4) | 0.1875 |
| rwPFS | 5.1(4.0,7.6) | 8.1(4.6,14.4) | 5.1(3.6,13.1) | 2.8(1.4,4.8) | 0.0193 |
NR, not reached.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
McKesson Life Sciences.
Funding
Merck & Co.
Disclosure
C.L. Cowey: Research grant/Funding (institution): Merck & Co; Full/Part-time employment: US Oncology Network. M. Boyd, K.M. Aguilar, A. Beeks: Research grant/Funding (institution): Merck & Co; Full/Part-time employment: McKesson Life Sciences. C. Krepler, E. Scherrer: Full/Part-time employment: Merck & Co.