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Title: | Durability of response to immune checkpoint inhibitors in metastatic Merkel cell carcinoma after treatment cessation |
Authors: | Weppler, A. M.;Da Meda, L.;da Silva, Ines Pires;Xu, W.;Grignani, G.;Menzies, A. M.;Carlino, Matteo S.;Long, G. V.;Lo, S. N.;Nordman, I.;Steer, C. B.;Lyle, M.;Trojaniello, C.;Ascierto, P. A.;Lebbe, C.;Sandhu, S. |
WSLHD Author: | da Silva, Ines Pires;Carlino, Matteo S. |
Issue Date: | 2023 |
Citation: | European Journal of Cancer 183:109-118, 2023 |
Abstract: | BACKGROUND: Metastatic Merkel cell carcinoma (mMCC) is highly responsive to immune checkpoint inhibitors (ICIs); however, durability of response after treatment cessation and response to retreatment in the setting of progression is unknown. METHODS: Patients (pts) having mMCC from 10 centres who discontinued ICI treatment for a reason other than progression were studied. RESULTS: Forty patients were included. Median time on treatment was 13.5 months (range 1-35). Thirty-one patients (77.5%) stopped treatment electively while 9 patients (22.5%) stopped due to treatment-related toxicity. After median of 12.3 months from discontinuation, 14 pts (35%) have progressed (PD). Disease progression rate following ICI discontinuation was 26% (8 of 31) in patients who discontinued in complete response (CR), 57% (4 of 7) in patients in partial response and 100% (2 of 2) in those with stable disease. Median progression-free survival (PFS) after treatment cessation was 21 months (95% confidence interval [CI], 18- not reached [NR]), with a third of patients progressing during their first year off treatment. PFS was longer for patients who discontinued ICI electively (median PFS 29 months; 95% CI, 21-NR) compared to those who stopped due to toxicity (median PFS 11 months; 95% CI, 10-NR). ICI was restarted in 8 of 14 pts (57%) with PD, with response rate of 75% (4 CR, 2 partial response, 1 stable disease, 1 PD). CONCLUSIONS: ICI responses in mMCC do not appear durable off treatment, including in patients who achieve a CR, though response to retreatment is promising. Extended duration of treatment needs to be investigated to optimise long-term outcomes. |
URI: | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/7202 |
DOI: | https://dx.doi.org/10.1016/j.ejca.2023.01.016 |
Journal: | European Journal of Cancer |
Type: | Journal Article |
Study or Trial: | Controlled Study Multicentre Study |
Department: | Oncology |
Facility: | Blacktown Westmead |
Affiliated Organisations: | Peter MacCallum Cancer Centre, Melbourne, Australia Institut du cancer AP-HP. Nord �?? UniversitǸ Paris CitǸ Dermato-Oncology, H��pital Saint Louis, Paris, France Melanoma Institute of Australia, The University of Sydney, Australia Faculty of Medicine and Health, The University of Sydney, Australia Westmead & Blacktown Hospital, Sydney, Australia Princess Alexandra Hospital, Brisbane, Australia The University of Queensland, Brisbane, Australia Candiolo Cancer Institute, FPO e IRCCS, Candiolo (TO), Italy Royal North Shore and Mater Hospitals, Sydney, Australia Calvary Mater Newcastle, Waratah, Australia University of Newcastle, Newcastle, Australia Border Medical Oncology, Albury Wodonga Regional Cancer Centre, Albury, Australia Cairns Hospital, Cairns, Australia University of NSW, Rural Clinical Campus, Albury, Australia Cairns Hospital, Cairns, Australia James Cook University, Cairns, Australia Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, Italy |
Keywords: | carcinoma, merkel cell immune checkpoint inhibitor skin neoplasms |
Appears in Collections: | Blacktown Mount Druitt Hospital |
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