Real-life effectiveness on overall survival of continued immune checkpoint inhibition following progression in advanced melanoma: estimation from the Melbase cohort
The link between palliative care and oncology must continue to develop, taking into account advances in treatment.Immune checkpoint inhibition (ICI) for metastatic melanoma is associated with different types of response, making it difficult to assess the benefits to the patient. Some clinical trials suggest a survival advantage of ICI even in the absence of an objective radiographic response. The aim of this study is to assess the impact of continuing ICI after progression of the disease on the overall survival (OS) in a cohort of final-line metastatic melanoma patients. Clinical data from 120 patients with metastatic melanoma were collected via Melbase, a French multicentric biobank, prospectively enrolling unresectable melanoma. Two groups were defined: patients continuing final-line ICI at progression (treated) and patients stopping ICI at progression (controls). The primary end-point is the OS from progression. Propensity score weighting was used to correct for indication bias. From the 120 patients, 72 (60%) continued ICI. Median OS from progression was 4.2 months [95% confidence interval (CI) 2.6-6.27] in the treated group and median OS was 1.3 months (95% CI 0.95-1.74) in the control group ( P < 0.0001). The calculated hazard ratio was 0.20 (0.13-0.33). Continued ICI was discovered to have an association with a higher rate of hospitalization at the end of life; more treatments received in the last 15 days of life and less utilization of specialist palliative care. This study discovered that patients with metastatic melanoma show a significant decrease in the instantaneous probability of mortality when they continue with finale-line ICI after progression.
Authors
- Julie De Quatrebarbes (ORCID: https://orcid.org/0009-0000-4584-044X)
- M.‐T. Leccia (ORCID: https://orcid.org/0000-0003-1222-0396)
- O. Dereure (ORCID: https://orcid.org/0000-0001-8736-1922)
- Chloé Prodhomme (ORCID: https://orcid.org/0000-0002-1990-5219)
- Wendy Lefevre
- Célèste Lebbé (ORCID: https://orcid.org/0000-0002-5854-7290)
- S. Dalac (ORCID: https://orcid.org/0000-0002-9101-3119)
- Thierry Lesimple (ORCID: https://orcid.org/0000-0002-1360-5135)
- Philippe Saïag (ORCID: https://orcid.org/0000-0002-6500-3507)
- F. Granel‐Brocard
- Henri Montaudié (ORCID: https://orcid.org/0000-0002-0528-4829)
- E. Maubec (ORCID: https://orcid.org/0000-0003-1658-6686)
- F. Aubin (ORCID: https://orcid.org/0000-0002-1421-4996)
- Délphine Legoupil (ORCID: https://orcid.org/0000-0002-1194-7668)
- Camille Macaire
- Caroline Dutriaux (ORCID: https://orcid.org/0000-0002-9836-5168)
- Jean‐Jacques Grob (ORCID: https://orcid.org/0000-0002-0667-153X)
- Stéphane Dalle (ORCID: https://orcid.org/0000-0002-3423-4548)
- Laurent Mortier (ORCID: https://orcid.org/0000-0002-2644-1790)
Institutions
- Lyon College (US)
- Centre Hospitalier Universitaire de Grenoble (FR)
- Centre Hospitalier Universitaire de Lille (FR)
- Centre Hospitalier Universitaire de Besançon (FR)
- Lille’s Cardiology Hospital (FR)
- Centre Hospitalier Universitaire de Montpellier (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Centre Hospitalier Régional et Universitaire de Nancy (FR)
- Centre Eugène Marquis (FR)
- Hôpital Saint-André (FR)
- Hôpital Nord (FR)
- CHU Dijon Bourgogne (FR)
- Hôpital l'Archet (FR)
- Hôpital Avicenne (FR)
- Centre Hospitalier Régional Universitaire de Brest (FR)
- Hôpital Ambroise-Paré (FR)
- Centre Hospitalier Annecy Genevois (FR)
- Groupe Hospitalier de l'Institut Catholique de Lille (FR)
- Hôpital Saint-Louis (FR)
- Hôpital Claude Huriez (FR)
Publication Details
- Journal
- Melanoma Research
- Published
- 2024-11-11
- DOI
- https://doi.org/10.1097/cmr.0000000000000973
- Citations
- 2
- Primary Topic
- Cancer Immunotherapy and Biomarkers
- Type
- article
- Field-Weighted Citation Impact
- 0.57
Funders
- Institut National Du Cancer
- National Cancer Institute