Cargando…

Pembrolizumab Utilization and Clinical Outcomes Among Patients With Advanced Melanoma in the US Community Oncology Setting: An Updated Analysis

Favorable outcomes have been observed with pembrolizumab among patients with advanced melanoma in clinical trials; however, limited evidence exists on the long-term efficacy in the real-world setting. This was an updated, retrospective observational study of adult patients with advanced (unresectabl...

Descripción completa

Detalles Bibliográficos
Autores principales: Cowey, Charles Lance, Scherrer, Emilie, Boyd, Marley, Aguilar, Kathleen M., Beeks, April, Krepler, Clemens
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191741/
https://www.ncbi.nlm.nih.gov/pubmed/33734142
http://dx.doi.org/10.1097/CJI.0000000000000363
_version_ 1783705920066289664
author Cowey, Charles Lance
Scherrer, Emilie
Boyd, Marley
Aguilar, Kathleen M.
Beeks, April
Krepler, Clemens
author_facet Cowey, Charles Lance
Scherrer, Emilie
Boyd, Marley
Aguilar, Kathleen M.
Beeks, April
Krepler, Clemens
author_sort Cowey, Charles Lance
collection PubMed
description Favorable outcomes have been observed with pembrolizumab among patients with advanced melanoma in clinical trials; however, limited evidence exists on the long-term efficacy in the real-world setting. This was an updated, retrospective observational study of adult patients with advanced (unresectable or metastatic) melanoma who initiated pembrolizumab (in any line of therapy) between January 1, 2014, and December 31, 2016, in The US Oncology Network and were followed through December 31, 2019 [median follow-up: 18.2 mo (range: 0.1–63.1 mo)]. Study data were sourced from electronic health records. Patient demographic, clinical, and treatment characteristics were assessed descriptively. Kaplan-Meier methods were used to evaluate overall survival (OS), time to treatment discontinuation, time to next treatment, physician-assessed time to tumor progression, and physician-assessed progression-free survival (rwPFS). Independent risk factors for OS and rwPFS were identified with multivariable Cox regression models. Of the 303 study-eligible patients, 119, 131, and 53 received pembrolizumab in the first-line, second-line, and third-line or beyond setting, respectively. Median OS across the study population was 29.3 months [95% confidence interval (CI): 20.3–49.7] and was the longest among those who received first-line pembrolizumab [42.8 mo (95% CI: 24.8–not reached)]. Median rwPFS across the study population was 5.1 months (95% CI: 4.0–7.6) and 8.1 months (95% CI: 4.6–14.4) among those who received first-line pembrolizumab. In the multivariable analyses for OS, increased age, worsening performance status, elevated lactate dehydrogenase, brain metastases, and pembrolizumab use in later lines were significantly associated a worse prognosis.
format Online
Article
Text
id pubmed-8191741
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-81917412021-06-16 Pembrolizumab Utilization and Clinical Outcomes Among Patients With Advanced Melanoma in the US Community Oncology Setting: An Updated Analysis Cowey, Charles Lance Scherrer, Emilie Boyd, Marley Aguilar, Kathleen M. Beeks, April Krepler, Clemens J Immunother Clinical Studies Favorable outcomes have been observed with pembrolizumab among patients with advanced melanoma in clinical trials; however, limited evidence exists on the long-term efficacy in the real-world setting. This was an updated, retrospective observational study of adult patients with advanced (unresectable or metastatic) melanoma who initiated pembrolizumab (in any line of therapy) between January 1, 2014, and December 31, 2016, in The US Oncology Network and were followed through December 31, 2019 [median follow-up: 18.2 mo (range: 0.1–63.1 mo)]. Study data were sourced from electronic health records. Patient demographic, clinical, and treatment characteristics were assessed descriptively. Kaplan-Meier methods were used to evaluate overall survival (OS), time to treatment discontinuation, time to next treatment, physician-assessed time to tumor progression, and physician-assessed progression-free survival (rwPFS). Independent risk factors for OS and rwPFS were identified with multivariable Cox regression models. Of the 303 study-eligible patients, 119, 131, and 53 received pembrolizumab in the first-line, second-line, and third-line or beyond setting, respectively. Median OS across the study population was 29.3 months [95% confidence interval (CI): 20.3–49.7] and was the longest among those who received first-line pembrolizumab [42.8 mo (95% CI: 24.8–not reached)]. Median rwPFS across the study population was 5.1 months (95% CI: 4.0–7.6) and 8.1 months (95% CI: 4.6–14.4) among those who received first-line pembrolizumab. In the multivariable analyses for OS, increased age, worsening performance status, elevated lactate dehydrogenase, brain metastases, and pembrolizumab use in later lines were significantly associated a worse prognosis. Lippincott Williams & Wilkins 2021 2021-03-17 /pmc/articles/PMC8191741/ /pubmed/33734142 http://dx.doi.org/10.1097/CJI.0000000000000363 Text en Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Clinical Studies
Cowey, Charles Lance
Scherrer, Emilie
Boyd, Marley
Aguilar, Kathleen M.
Beeks, April
Krepler, Clemens
Pembrolizumab Utilization and Clinical Outcomes Among Patients With Advanced Melanoma in the US Community Oncology Setting: An Updated Analysis
title Pembrolizumab Utilization and Clinical Outcomes Among Patients With Advanced Melanoma in the US Community Oncology Setting: An Updated Analysis
title_full Pembrolizumab Utilization and Clinical Outcomes Among Patients With Advanced Melanoma in the US Community Oncology Setting: An Updated Analysis
title_fullStr Pembrolizumab Utilization and Clinical Outcomes Among Patients With Advanced Melanoma in the US Community Oncology Setting: An Updated Analysis
title_full_unstemmed Pembrolizumab Utilization and Clinical Outcomes Among Patients With Advanced Melanoma in the US Community Oncology Setting: An Updated Analysis
title_short Pembrolizumab Utilization and Clinical Outcomes Among Patients With Advanced Melanoma in the US Community Oncology Setting: An Updated Analysis
title_sort pembrolizumab utilization and clinical outcomes among patients with advanced melanoma in the us community oncology setting: an updated analysis
topic Clinical Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191741/
https://www.ncbi.nlm.nih.gov/pubmed/33734142
http://dx.doi.org/10.1097/CJI.0000000000000363
work_keys_str_mv AT coweycharleslance pembrolizumabutilizationandclinicaloutcomesamongpatientswithadvancedmelanomaintheuscommunityoncologysettinganupdatedanalysis
AT scherreremilie pembrolizumabutilizationandclinicaloutcomesamongpatientswithadvancedmelanomaintheuscommunityoncologysettinganupdatedanalysis
AT boydmarley pembrolizumabutilizationandclinicaloutcomesamongpatientswithadvancedmelanomaintheuscommunityoncologysettinganupdatedanalysis
AT aguilarkathleenm pembrolizumabutilizationandclinicaloutcomesamongpatientswithadvancedmelanomaintheuscommunityoncologysettinganupdatedanalysis
AT beeksapril pembrolizumabutilizationandclinicaloutcomesamongpatientswithadvancedmelanomaintheuscommunityoncologysettinganupdatedanalysis
AT kreplerclemens pembrolizumabutilizationandclinicaloutcomesamongpatientswithadvancedmelanomaintheuscommunityoncologysettinganupdatedanalysis