RT Journal Article
SR Electronic
T1 Ipilimumab plus nivolumab for patients with metastatic uveal melanoma: a multicenter, retrospective study
JF Journal for ImmunoTherapy of Cancer
JO J Immunother Cancer
FD BMJ Publishing Group Ltd
SP e000331
DO 10.1136/jitc-2019-000331
VO 8
IS 1
A1 Yana G Najjar
A1 Kristina Navrazhina
A1 Fei Ding
A1 Roma Bhatia
A1 Katy Tsai
A1 Kelly Abbate
A1 Barbara Durden
A1 Zeynep Eroglu
A1 Shailender Bhatia
A1 Song Park
A1 Akansha Chowdhary
A1 Sunandana Chandra
A1 Jonathan Kennedy
A1 Igor Puzanov
A1 Marc Ernstoff
A1 Pankit Vachhani
A1 Joseph Drabick
A1 Arun Singh
A1 Tan Xu
A1 Jessica Yang
A1 Richard Carvajal
A1 Daniel Manson
A1 John M Kirkwood
A1 Justine Cohen
A1 Ryan Sullivan
A1 Douglas Johnson
A1 Pauline Funchain
A1 Alexander Shoushtari
YR 2020
UL http://jitc.bmj.com/content/8/1/e000331.abstract
AB Background Uveal melanoma (UM) is the most common intraocular malignancy in adults. In contrast to cutaneous melanoma (CM), there is no standard therapy, and the efficacy and safety of dual checkpoint blockade with nivolumab and ipilimumab is not well defined.Methods We conducted a retrospective analysis of patients with metastatic UM (mUM) who received treatment with ipilimumab plus nivolumab across 14 academic medical centers. Toxicity was graded using National Cancer Institute Common Terminology Criteria for Adverse Events V.5.0. Progression-free survival (PFS) and overall survival (OS) were calculated using Kaplan-Meier methodology.Results 89 eligible patients were identified. 45% had received prior therapy, which included liver directed therapy (29%), immunotherapy (21%), targeted therapy (10%) and radiation (16%). Patients received a median 3 cycles of ipilimumab plus nivolumab. The median follow-up time was 9.2 months. Overall response rate was 11.6%. One patient achieved complete response (1%), 9 patients had partial response (10%), 21 patients had stable disease (24%) and 55 patients had progressive disease (62%). Median OS from treatment initiation was 15 months and median PFS was 2.7 months. Overall, 82 (92%) of patients discontinued treatment, 34 due to toxicity and 27 due to progressive disease. Common immune-related adverse events were colitis/diarrhea (32%), fatigue (23%), rash (21%) and transaminitis (21%).Conclusions Dual checkpoint inhibition yielded higher response rates than previous reports of single-agent immunotherapy in patients with mUM, but the efficacy is lower than in metastatic CM. The median OS of 15 months suggests that the rate of clinical benefit may be larger than the modest response rate.