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Chemotherapy efficacy after first-line immunotherapy in 18 advanced melanoma patients

Abstract : In BRAF wild type advanced melanoma, immune checkpoint blockers such as anti-PD1 (anti-programmed cell death 1) are usually continued beyond progression for a hypothetical rare further response. Chemotherapy as a second-line option is considered ineffective by many practitioners based on historical data. Continuing anti-PD1 beyond progression has a high health-economic impact and is not recommended by the FDA. This study aimed to describe the efficacy and survival of advanced melanoma patients who received second-line (or more) chemotherapy after immunotherapy failure. This was a retrospective single center study conducted in a French University Hospital during an 11-month period. All advanced melanoma patients treated with chemotherapy after immunotherapy failure were included. Eighteen patients were analyzed. Therapeutic response to chemotherapy was evaluable in 16 patients: partial response was achieved in 3/16 (19%), stable disease in 1/16 (6%) and progressive disease in 12/16 (75%). Median overall survival from chemotherapy start was 12 months. Median progression-free survival was 5.4 months. The 6-month overall survival rate was 81% and the 6-month progression-free survival rate was 40%. Although the disease control rate with chemotherapy was low (25%), survival data in our study are far superior to those previously published. This could be linked to a high proportion of patients treated with anti-PD1 just prior to chemotherapy, which may suggest a potential synergy between immunotherapy and chemotherapy.
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Submitted on : Thursday, June 30, 2022 - 1:39:17 PM
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Mélanie Saint-Jean, Clémentine Fronteau, Lucie Peuvrel, Amir Khammari, Emilie Varey, et al.. Chemotherapy efficacy after first-line immunotherapy in 18 advanced melanoma patients. Medicine, Lippincott, Williams & Wilkins, 2020, 99 (29), pp.e21329. ⟨10.1097/md.0000000000021329⟩. ⟨inserm-03710014⟩



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