Baseline tumor size is an independent prognostic factor for overall survival in patients with melanoma treated with pembrolizumab Journal Article


Authors: Joseph, R. W.; Elassaiss-Schaap, J.; Kefford, R.; Hwu, W. J.; Wolchok, J. D.; Joshua, A. M.; Ribas, A.; Hodi, F. S.; Hamid, O.; Robert, C.; Daud, A.; Dronca, R.; Hersey, P.; Weber, J. S.; Patnaik, A.; de Alwis, D. P.; Perrone, A.; Zhang, J.; Kang, S. P.; Ebbinghaus, S.; Anderson, K. M.; Gangadhar, T. C.
Article Title: Baseline tumor size is an independent prognostic factor for overall survival in patients with melanoma treated with pembrolizumab
Abstract: Purpose: The purpose of this study was to assess the association of baseline tumor size (BTS) with other baseline clinical factors and outcomes in pembrolizumab-treated patients with advanced melanoma in KEYNOTE-001 (NCT01295827). Experimental Design: BTS was quantified by adding the sum of the longest dimensions of all measurable baseline target lesions. BTS as a dichotomous and continuous variable was evaluated with other baseline factors using logistic regression for objective response rate (ORR) and Cox regression for overall survival (OS). Nominal P values with no multiplicity adjustment describe the strength of observed associations. Results: Per central review by RECIST v1.1, 583 of 655 patients had baseline measurable disease and were included in this post hoc analysis. Median BTS was 10.2 cm (range, 1-89.5). Larger median BTS was associated with Eastern Cooperative Oncology Group performance status 1, elevated lactate dehydrogenase (LDH), stage M1c disease, and liver metastases (with or without any other sites; all P <= 0.001). In univariate analyses, BTS below the median was associated with higher ORR (44% vs. 23%; P < 0.001) and improved OS (HR, 0.38; P < 0.001). In multivariate analyses, BTS below the median remained an independent prognostic marker of OS (P < 0.001) but not ORR. In 459 patients with available tumor programmed death ligand 1 (PD-L1) expression, BTS below the median and PD-L1-positive tumors were independently associated with higher ORR and longer OS. Conclusions: BTS is associated with many other baseline clinical factors but is also independently prognostic of survival in pembrolizumab-treated patients with advanced melanoma. (C) 2018 AACR.
Keywords: ipilimumab; therapy; metastatic melanoma; randomized-trials; version; anti-pd-1
Journal Title: Clinical Cancer Research
Volume: 24
Issue: 20
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2018-10-15
Start Page: 4960
End Page: 4967
Language: English
ACCESSION: WOS:000447598900007
DOI: 10.1158/1078-0432.ccr-17-2386
PROVIDER: wos
PUBMED: 29685882
Notes: Article -- Source: Wos
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  1. Jedd D Wolchok
    637 Wolchok