Real-world experience with pembrolizumab in patients with advanced melanoma

Liu, Frank Xiaoqing; Ou, Wanmei; Diede, Scott J.; Whitman, Eric D.

doi:10.1097/md.0000000000016542

Cited by 29 publications

(26 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since 2011, a series of novel immuno-oncology (I-O) agents, targeted therapies, and combination regimens have been approved. 1 Robust data from phase III trials [2][3][4][5][6][7] and subsequent real-world evidence [8][9][10] have unequivocally demonstrated overall survival (OS) and progression-free survival (PFS) benefits with these agents. As the follow-up of pivotal trials continues, a substantial body of long-term data is emerging that supports the durability of survival with some agents.…”

Section: Introductionmentioning

confidence: 99%

Evolving impact of long-term survival results on metastatic melanoma treatment

Michielin

Atkins

Koon

et al. 2020

J Immunother Cancer

View full text Add to dashboard Cite

Melanoma treatment has been revolutionized over the past decade. Long-term results with immuno-oncology (I-O) agents and targeted therapies are providing evidence of durable survival for a substantial number of patients. These results have prompted consideration of how best to define long-term benefit and cure. Now more than ever, oncologists should be aware of the long-term outcomes demonstrated with these newer agents and their relevance to treatment decision-making. As the first tumor type for which I-O agents were approved, melanoma has served as a model for other diseases. Accordingly, discussions regarding the value and impact of long-term survival data in patients with melanoma may be relevant in the future to other tumor types. Current findings indicate that, depending on the treatment, over 50% of patients with melanoma may gain durable survival benefit. The best survival outcomes are generally observed in patients with favorable prognostic factors, particularly normal baseline lactate dehydrogenase and/or a low volume of disease. Survival curves from melanoma clinical studies show a plateau at 3 to 4 years, suggesting that patients who are alive at the 3-year landmark (especially in cases in which treatment had been stopped) will likely experience prolonged cancer remission. Quality-of-life and mixture-cure modeling data, as well as metrics such as treatment-free survival, are helping to define the value of this long-term survival. In this review, we describe the current treatment landscape for melanoma and discuss the long-term survival data with immunotherapies and targeted therapies, discussing how to best evaluate the value of long-term survival. We propose that some patients might be considered functionally cured if they have responded to treatment and remained treatment-free for at least 2 years without disease progression. Finally, we consider that, while there have been major advances in the treatment of melanoma in the past decade, there remains a need to improve outcomes for the patients with melanoma who do not experience durable survival.

show abstract

Section: Introductionmentioning

confidence: 99%

Evolving impact of long-term survival results on metastatic melanoma treatment

Michielin

Atkins

Koon

et al. 2020

J Immunother Cancer

View full text Add to dashboard Cite

show abstract

“…Recent studies exploring the real-world treatment patterns among all adults for late-stage melanoma reported that only 34% to 37% of the patients received ICI as the first-line treatment, despite the recommendation by the NCCN guidelines. [ 24 – 26 ] The rates of treatment with ICI in our study is very low (6%). A plausible reason for the low rate can be due to the differences in population studied.…”

Section: Discussionmentioning

confidence: 60%

Factors associated with immune checkpoint inhibitor use among older adults with late-stage melanoma

et al. 2021

View full text Add to dashboard Cite

Improvement in overall survival by immune checkpoint inhibitors (ICI) treatment in clinical trials encourages their use for late-stage melanoma. However, in the real-world, heterogeneity of population, such as older patients with multimorbidity, may lead to a slower diffusion of ICIs. The objective of this study was to examine the association of multimorbidity and other factors to ICI use among older patients with late-stage melanoma using real world data. A retrospective cohort study design with a 12-month baseline and follow-up period was adopted with data from the linked Surveillance, Epidemiology, and End Results cancer registry/Medicare database. Older patients (>65 years) with late-stage (stage III/IV) melanoma diagnosed between 2012 and 2015 were categorized as with or without multimorbidity (presence of 2 or more chronic conditions) and ICI use was identified in the post-index period. Chi-square tests and logistic regression were used to evaluate factors associated with ICI use. In the study cohort, 85% had multimorbidity, 18% received any treatment (chemotherapy, radiation, and/or ICI), and 6% received ICI. Only 5.5% of older patients with multimorbidity and 6% without multimorbidity received ICIs. Younger age, presence of social support, lower economic status, residence in northeastern regions, and recent year of diagnosis were significantly associated with ICI use; however, multimorbidity, sex, and race were not associated with ICI use. In the real-world clinical practice, only 1 in 18 older adults with late stage melanoma received ICI, suggesting slow pace of diffusion of innovation. However, multimorbidity was not a barrier to ICI use.

show abstract

“…These findings demonstrate the effectiveness of pembrolizumab in the actual clinical setting. 34 Another study found that pembrolizumab was used for intravenous infusion (escalating doses 2 or 10 mg/kg) until disease progression or severe toxicity. During the study, 80% of patients had nausea and fever, and it elevated aspartate aminotransferase/alanine aminotransferase.…”

Section: Anti-pd-1 Prevent Malignant Tumorsmentioning

confidence: 99%

PD-1 Immune Checkpoint Inhibitor Therapy Malignant Tumor Based on Monotherapy and Combined Treatment Research

Mou

et al. 2021

Technol Cancer Res Treat

View full text Add to dashboard Cite

Recently, immunotherapy has become the fourth pillar of cancer treatment in addition to surgery therapy, chemotherapy, and radiation therapy. The inhibitors of programed cell death protein 1 (PD-1) and its ligand PD-L1 are the new stars in immunotherapy, as they can overcome tumor immunosuppression. However, the efficacy of PD-1 inhibitors still needs to be further developed for clinical treatment. Therefore, research into treatment with anti-PD-1 drugs has emerged as a new development field. This review provides novel insights into the role and mechanism of PD-1 combination anti-tumor therapy, thereby promoting its clinical application in anti-tumor immunotherapy.

show abstract

Real-world experience with pembrolizumab in patients with advanced melanoma

Abstract: Supplemental Digital Content is available in the text

Cited by 29 publications

References 45 publications

Evolving impact of long-term survival results on metastatic melanoma treatment

Evolving impact of long-term survival results on metastatic melanoma treatment

Factors associated with immune checkpoint inhibitor use among older adults with late-stage melanoma

PD-1 Immune Checkpoint Inhibitor Therapy Malignant Tumor Based on Monotherapy and Combined Treatment Research

Contact Info

Product

Resources

About