Clinical outcomes in metastatic uveal melanoma treated with PD-1 and PD-L1 antibodies Journal Article


Authors: Algazi, A. P.; Tsai, K. K.; Shoushtari, A. N.; Munhoz, R. R.; Eroglu, Z.; Piulats, J. M.; Ott, P. A.; Johnson, D. B.; Hwang, J.; Daud, A. I.; Sosman, J. A.; Carvajal, R. D.; Chmielowski, B.; Postow, M. A.; Weber, J. S.; Sullivan, R. J.
Article Title: Clinical outcomes in metastatic uveal melanoma treated with PD-1 and PD-L1 antibodies
Abstract: BACKGROUND: Antibodies inhibiting the programmed death receptor 1 (PD-1) have demonstrated significant activity in the treatment of advanced cutaneous melanoma. The efficacy and safety of PD-1 blockade in patients with uveal melanoma has not been well characterized. METHODS: Fifty-eight patients with stage IV uveal melanoma received PD-1 or PD-1 ligand (PD-L1) antibodies between 2009 and 2015 at 9 academic centers. Patients who were evaluable for response were eligible for the analysis. Imaging was performed every 12 weeks and at the investigators' discretion. Safety and clinical efficacy outcomes, including the best overall response, progression-free survival (PFS), and overall survival (OS), were retrospectively determined. RESULTS: Of 56 eligible patients, 48 (86%) had received prior therapy, and 35 (63%) had received treatment with ipilimumab. Three patients had an objective response to ipilimumab, and 8 had stable disease as their best response. Thirty-eight patients (68%) received pembrolizumab, 16 (29%) received nivolumab, and 2 (4%) received atezolizumab. Objective tumor responses were observed in 2 patients for an overall response rate of 3.6% (95% confidence interval [CI], 1.8%-22.5%). Stable disease (≥6 months) was observed in 5 patients (9%). The median PFS was 2.6 months (95% CI, 2.4-2.8 months), and the median OS was 7.6 months (95% CI, 0.7-14.6 months). There was no association between prior treatment with ipilimumab or liver-directed therapy and PFS or OS. Treatment was well tolerated, and only 1 patient discontinued treatment because of toxicity. CONCLUSIONS: PD-1 and PD-L1 antibodies rarely confer durable remissions in patients with metastatic uveal melanoma. Clinical trial enrollment should be prioritized in this population. Cancer 2016;122:3344–3353. © 2016 American Cancer Society. © 2016 American Cancer Society
Keywords: immunotherapy; uveal melanoma; nivolumab; pembrolizumab; atezolizumab
Journal Title: Cancer
Volume: 122
Issue: 21
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2016-11-01
Start Page: 3344
End Page: 3353
Language: English
DOI: 10.1002/cncr.30258
PROVIDER: scopus
PUBMED: 27533448
PMCID: PMC5767160
DOI/URL:
Notes: Article -- Export Date: 2 November 2016 -- Source: Scopus
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  1. Michael Andrew Postow
    361 Postow
  2. Rodrigo Ramella Munhoz
    19 Munhoz