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Comparison Between First Line Target Therapy and Immunotherapy in Different Prognostic Categories of BRAF Mutant Metastatic Melanoma Patients: An Italian Melanoma Intergroup Study

BACKGROUND: BRAF and MEK inhibitors target therapies (TT) and AntiPD1 immunotherapies (IT) are available first-line treatments for BRAF v600 mutant metastatic melanoma patients. ECOG PS (E), baseline LDH (L), and baseline number of metastatic sites (N) are well-known clinical prognostic markers that...

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Autores principales: Marconcini, Riccardo, Fava, Paolo, Nuzzo, Amedeo, Manacorda, Simona, Ferrari, Marco, De Rosa, Francesco, De Tursi, Michele, Tanda, Enrica Teresa, Consoli, Francesca, Minisini, Alessandro, Pimpinelli, Nicola, Morgese, Francesca, Bersanelli, Melissa, Tucci, Marco, Saponara, Maristella, Parisi, Alessandro, Ocelli, Marcella, Bazzurri, Serena, Massaro, Giulia, Morganti, Riccardo, Ciardetti, Isabella, Stanganelli, Ignazio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9421680/
https://www.ncbi.nlm.nih.gov/pubmed/36046043
http://dx.doi.org/10.3389/fonc.2022.917999
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author Marconcini, Riccardo
Fava, Paolo
Nuzzo, Amedeo
Manacorda, Simona
Ferrari, Marco
De Rosa, Francesco
De Tursi, Michele
Tanda, Enrica Teresa
Consoli, Francesca
Minisini, Alessandro
Pimpinelli, Nicola
Morgese, Francesca
Bersanelli, Melissa
Tucci, Marco
Saponara, Maristella
Parisi, Alessandro
Ocelli, Marcella
Bazzurri, Serena
Massaro, Giulia
Morganti, Riccardo
Ciardetti, Isabella
Stanganelli, Ignazio
author_facet Marconcini, Riccardo
Fava, Paolo
Nuzzo, Amedeo
Manacorda, Simona
Ferrari, Marco
De Rosa, Francesco
De Tursi, Michele
Tanda, Enrica Teresa
Consoli, Francesca
Minisini, Alessandro
Pimpinelli, Nicola
Morgese, Francesca
Bersanelli, Melissa
Tucci, Marco
Saponara, Maristella
Parisi, Alessandro
Ocelli, Marcella
Bazzurri, Serena
Massaro, Giulia
Morganti, Riccardo
Ciardetti, Isabella
Stanganelli, Ignazio
author_sort Marconcini, Riccardo
collection PubMed
description BACKGROUND: BRAF and MEK inhibitors target therapies (TT) and AntiPD1 immunotherapies (IT) are available first-line treatments for BRAF v600 mutant metastatic melanoma patients. ECOG PS (E), baseline LDH (L), and baseline number of metastatic sites (N) are well-known clinical prognostic markers that identify different prognostic categories of patients. Direct comparison between first-line TT and IT in different prognostic categories could help in first line treatment decision. METHODS: This is a retrospective analysis conducted in 14 Italian centers on about 454 metastatic melanoma patients, divided in 3 groups: group A—patients with E = 0, L within normal range, and N less than 3; group B—patients not included in group A or C; group C—patients with E > 0, L over the normal range, and N more than 3. For each prognostic group, we compared TT and IT in terms of progression free survival (PFS), overall survival (OS), and disease control rate (DCR). RESULTS: In group A, results in 140 TT and 36 IT-treated patients were, respectively, median PFS 35.5 vs 11.6 months (HR (95% CI) 1.949 (1.180–3.217) p value 0.009); median OS not reached vs 55 months (HR (95% CI) 1.195 (0.602–2.373) p value 0.610); DCR 99% vs 75% p value <0.001). In group B, results in 196 TT and 38 IT-treated patients were, respectively, median PFS 11.5 vs 5 months (HR 1.535 (1.036–2.275) p value 0.033); median OS 19 vs 20 months (HR 0.886 (0.546–1.437) p value 0.623); DCR 85% vs 47% p value <0.001). In group C, results in 41 TT and 3 IT-treated patients were, respectively, median PFS 6.4 vs 1.8 months (HR 4.860 (1.399–16) p value 0.013); median OS 9 vs 5 months (HR 3.443 (0.991–11.9) p value 0.052); DCR 66% vs 33% p value 0.612). CONCLUSIONS: In good prognosis, group A—TT showed statistically significant better PFS than IT, also in a long-term period, suggesting that TT can be a good first line option for this patient category. It is only in group B that we observed a crossing of the survival curves after the 3rd year of observation in favor of IT. Few patients were enrolled in group C, so few conclusions can be made on it.
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spelling pubmed-94216802022-08-30 Comparison Between First Line Target Therapy and Immunotherapy in Different Prognostic Categories of BRAF Mutant Metastatic Melanoma Patients: An Italian Melanoma Intergroup Study Marconcini, Riccardo Fava, Paolo Nuzzo, Amedeo Manacorda, Simona Ferrari, Marco De Rosa, Francesco De Tursi, Michele Tanda, Enrica Teresa Consoli, Francesca Minisini, Alessandro Pimpinelli, Nicola Morgese, Francesca Bersanelli, Melissa Tucci, Marco Saponara, Maristella Parisi, Alessandro Ocelli, Marcella Bazzurri, Serena Massaro, Giulia Morganti, Riccardo Ciardetti, Isabella Stanganelli, Ignazio Front Oncol Oncology BACKGROUND: BRAF and MEK inhibitors target therapies (TT) and AntiPD1 immunotherapies (IT) are available first-line treatments for BRAF v600 mutant metastatic melanoma patients. ECOG PS (E), baseline LDH (L), and baseline number of metastatic sites (N) are well-known clinical prognostic markers that identify different prognostic categories of patients. Direct comparison between first-line TT and IT in different prognostic categories could help in first line treatment decision. METHODS: This is a retrospective analysis conducted in 14 Italian centers on about 454 metastatic melanoma patients, divided in 3 groups: group A—patients with E = 0, L within normal range, and N less than 3; group B—patients not included in group A or C; group C—patients with E > 0, L over the normal range, and N more than 3. For each prognostic group, we compared TT and IT in terms of progression free survival (PFS), overall survival (OS), and disease control rate (DCR). RESULTS: In group A, results in 140 TT and 36 IT-treated patients were, respectively, median PFS 35.5 vs 11.6 months (HR (95% CI) 1.949 (1.180–3.217) p value 0.009); median OS not reached vs 55 months (HR (95% CI) 1.195 (0.602–2.373) p value 0.610); DCR 99% vs 75% p value <0.001). In group B, results in 196 TT and 38 IT-treated patients were, respectively, median PFS 11.5 vs 5 months (HR 1.535 (1.036–2.275) p value 0.033); median OS 19 vs 20 months (HR 0.886 (0.546–1.437) p value 0.623); DCR 85% vs 47% p value <0.001). In group C, results in 41 TT and 3 IT-treated patients were, respectively, median PFS 6.4 vs 1.8 months (HR 4.860 (1.399–16) p value 0.013); median OS 9 vs 5 months (HR 3.443 (0.991–11.9) p value 0.052); DCR 66% vs 33% p value 0.612). CONCLUSIONS: In good prognosis, group A—TT showed statistically significant better PFS than IT, also in a long-term period, suggesting that TT can be a good first line option for this patient category. It is only in group B that we observed a crossing of the survival curves after the 3rd year of observation in favor of IT. Few patients were enrolled in group C, so few conclusions can be made on it. Frontiers Media S.A. 2022-08-15 /pmc/articles/PMC9421680/ /pubmed/36046043 http://dx.doi.org/10.3389/fonc.2022.917999 Text en Copyright © 2022 Marconcini, Fava, Nuzzo, Manacorda, Ferrari, De Rosa, De Tursi, Tanda, Consoli, Minisini, Pimpinelli, Morgese, Bersanelli, Tucci, Saponara, Parisi, Ocelli, Bazzurri, Massaro, Morganti, Ciardetti and Stanganelli https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Marconcini, Riccardo
Fava, Paolo
Nuzzo, Amedeo
Manacorda, Simona
Ferrari, Marco
De Rosa, Francesco
De Tursi, Michele
Tanda, Enrica Teresa
Consoli, Francesca
Minisini, Alessandro
Pimpinelli, Nicola
Morgese, Francesca
Bersanelli, Melissa
Tucci, Marco
Saponara, Maristella
Parisi, Alessandro
Ocelli, Marcella
Bazzurri, Serena
Massaro, Giulia
Morganti, Riccardo
Ciardetti, Isabella
Stanganelli, Ignazio
Comparison Between First Line Target Therapy and Immunotherapy in Different Prognostic Categories of BRAF Mutant Metastatic Melanoma Patients: An Italian Melanoma Intergroup Study
title Comparison Between First Line Target Therapy and Immunotherapy in Different Prognostic Categories of BRAF Mutant Metastatic Melanoma Patients: An Italian Melanoma Intergroup Study
title_full Comparison Between First Line Target Therapy and Immunotherapy in Different Prognostic Categories of BRAF Mutant Metastatic Melanoma Patients: An Italian Melanoma Intergroup Study
title_fullStr Comparison Between First Line Target Therapy and Immunotherapy in Different Prognostic Categories of BRAF Mutant Metastatic Melanoma Patients: An Italian Melanoma Intergroup Study
title_full_unstemmed Comparison Between First Line Target Therapy and Immunotherapy in Different Prognostic Categories of BRAF Mutant Metastatic Melanoma Patients: An Italian Melanoma Intergroup Study
title_short Comparison Between First Line Target Therapy and Immunotherapy in Different Prognostic Categories of BRAF Mutant Metastatic Melanoma Patients: An Italian Melanoma Intergroup Study
title_sort comparison between first line target therapy and immunotherapy in different prognostic categories of braf mutant metastatic melanoma patients: an italian melanoma intergroup study
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9421680/
https://www.ncbi.nlm.nih.gov/pubmed/36046043
http://dx.doi.org/10.3389/fonc.2022.917999
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