Skip to main content

ORIGINAL RESEARCH article

Front. Oncol.
Sec. Skin Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1385425

Imaging Response to Immune Checkpoint Inhibitors in Patients with Advanced Melanoma A Retrospective Observational Cohort Study

Provisionally accepted
Mehul Gupta Mehul Gupta Igor Stukalin Igor Stukalin *Daniel E. Meyers Daniel E. Meyers *Daniel Y. Heng Daniel Y. Heng *Jose Monzon Jose Monzon *Tina Cheng Tina Cheng *Vishal Navani Vishal Navani *
  • Tom Baker Cancer Centre, Calgary, Alberta, Canada

The final, formatted version of the article will be published soon.

    The association between objective imaging response and first line immune checkpoint inhibitor (ICI) therapy regimes in advanced melanoma remains uncharacterized in routine practice.We conducted a multi-center retrospective cohort analysis of advanced melanoma patients receiving first line ICI therapy from August 2013-May 2020 in Alberta, Canada. The primary outcome was likelihood of RECIST v1.1 assessed objective imaging response between patients receiving antiprogrammed cell death protein 1 (anti-PD1) monotherapy and those receiving combination ipilimumabnivolumab. Secondary outcomes were identification of baseline characteristics associated with nonresponse and the association of imaging response with overall survival (OS) and time to next treatment (TTNT).Results: 198 patients were included, 41/198 (20.7%) had complete response, 86/198 (43.4%) had partial response, 23/198 (11.6%) had stable disease, and 48/198 (24.2%) had progressive disease. Median OS was not reached (NR) (95% CI 49.0-NR) months for complete responders, NR (95%CI 52.9-NR) months for partial responders, 33.7 (95%CI 15.8-NR) months for stable disease, and 6.4 (95%CI 5.2-10.1) months for progressive disease (log-rank p<0.001). Likelihood of objective imaging response remained similar between anti-PD1 monotherapy and ipilimumab-nivolumab groups (OR 1.95 95%CI 0.85-4.63, p=0.121).Elevated LDH level (OR 0.46; 95%CI 0.21-0.98, p=0.043), mucosal primary site (OR 0.14; 95%CI 0.03-0.48, p=0.003), and BRAF V600E mutation status (OR 0.31; 95%CI 0.13-0.72, p=0.007) were associated with decreased likelihood of response.No significant difference in likelihood of imaging response between anti-PD1 monotherapy and combination ipilimumab-nivolumab was observed. Elevated LDH level, mucosal primary site, and BRAF V600E mutation status were associated with decreased likelihood of response. Given that pivotal clinical trials of ipilimumab-nivolumab did not formally compare ipilimumab-nivolumab with nivolumab monotherapy, this work adds context to differences in outcomes when these agents are used. These results may inform treatment selection, and aid in counseling of patients treated with first-line ICI therapy in routine clinical practice settings.

    Keywords: Melanoma, Immunotherapy, RECIST = Response Evaluation Criteria in Solid Tumors, Survival, prognosis

    Received: 12 Feb 2024; Accepted: 13 May 2024.

    Copyright: © 2024 Gupta, Stukalin, Meyers, Heng, Monzon, Cheng and Navani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Igor Stukalin, Tom Baker Cancer Centre, Calgary, T2N 4N2, Alberta, Canada
    Daniel E. Meyers, Tom Baker Cancer Centre, Calgary, T2N 4N2, Alberta, Canada
    Daniel Y. Heng, Tom Baker Cancer Centre, Calgary, T2N 4N2, Alberta, Canada
    Jose Monzon, Tom Baker Cancer Centre, Calgary, T2N 4N2, Alberta, Canada
    Tina Cheng, Tom Baker Cancer Centre, Calgary, T2N 4N2, Alberta, Canada
    Vishal Navani, Tom Baker Cancer Centre, Calgary, T2N 4N2, Alberta, Canada

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.