Prognostic factors for survival in patients with metastatic skin melanoma, receiving first-line treatment with anti-PD-1 or anti-PD-1 and anti-CTLA-4 immunotherapy regimen at the Instituto Nacional de Cancerología (Bogotá, Colombia)
DOI:
https://doi.org/10.35509/01239015.903Keywords:
Skin neoplasms, melanoma, neoplasm metastasis, immune checkpoint inhibitors, prognosis, survival analysisAbstract
Introduction: In metastatic melanoma, one of the standard treatments is anti-PD-1 and anti-CTLA-4 immunotherapy. This research aimed to determine prognostic factors associated with the survival of patients with metastatic melanoma who started first-line treatment with anti-PD-1 or anti-PD-1 and anti-CTLA-4 immunotherapy at the Instituto Nacional de Cancerología (INC) (Bogotá, Colombia).
Methods: A total of 63 medical records from the INC were reviewed from January 2016 to April 2020. A survival analysis was performed using the Kaplan-Meier method, log-rank test, and Cox regression.
Results: Most patients were women (58.7%); 47.6% had acral lentiginous subtype, 17.4% BRAF-mutated melanoma, 20.6% CNS involvement, 50.8% received nivolumab, 41.3% pembrolizumab, and 7.9% nivolumab + ipilimumab. Median progression-free survival (PFS) was 7.3 months with a rate at 1, 2, and 3 years of 38%, 22%, and 12%, respectively, while median overall survival (OS) was 12.2 months with a rate of 50%, 25%, and 19% at 1, 2, and 3 years, respectively. A protective prognostic factor for PFS was to receive nivolumab compared to pembrolizumab (HR=0.427; CI95% 0.21-0.86), and for OS, functional status at diagnosis (ECOG 2 HR=12.38; CI95% 2.20-69.45).
Conclusion: PFS and OS were lower than those of randomized clinical trials in the Caucasian population, but similar to those found in studies that include a higher proportion of the acral lentiginous histological subtype, such as ours. The type of immunotherapy used and functional status at diagnosis were found as prognostic factors.
Author Biographies
Andrea Marcela Zuluaga-Liberato, Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
1. Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Carlos Eduardo Bonilla-González, Fundación CTIC - Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo, Bogotá, D.C., Colombia.
Fundación CTIC - Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo, Bogotá, D.C., Colombia.
Fernando Contreras-Mejía, Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
1. Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
José Alexander Carreño-Dueñas, Grupo de Investigación Clínica y Epidemiológica del Cáncer, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
3. Grupo de Investigación Clínica y Epidemiológica del Cáncer, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
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