Safety assessment of anticancer drugs in association with radiotherapy in metastatic malignant melanoma: a real-life report

Couty, E.; Vallard, Alexis; Sotton, Sandrine; Ouni, S.; Garcia, Max-Adrien; Espenel, Sophie; Rancoule, C.; Mrad, Majed Ben; Biron, A; Perrot, Jean‐Luc; Langrand-Escure, Julien; Magné, Nicolas

doi:10.1007/s00280-019-03806-5

Cited by 5 publications

(3 citation statements)

References 43 publications

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“…The incidence of grade 3 or grade 4 adverse events in the present study was only 1.6%. Moreover, compared with ICB monotherapy, combination therapy with ICB and RT did not induce supra-additive toxicity [25,28]. In line with our findings, the results of a multicenter study revealed that concurrent PD-1 blocker therapy and RT did not increase or add to previously reported toxicity for PD-1 blockers or RT alone [29].…”

Section: Discussionsupporting

confidence: 89%

Clinical Outcomes of Immune Checkpoint Blocker Therapy for Malignant Melanoma in Korean Patients: Potential Clinical Implications for a Combination Strategy Involving Radiotherapy

et al. 2020

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PurposeWe investigated the clinical efficacy of immune checkpoint blocker (ICB) therapy for metastatic or advanced melanoma in Korean patients. As well, we assessed whether the effects of ICBs can be enhanced by combination therapy with palliative radiotherapy (RT).Materials and MethodsWe retrospectively reviewed the records of 127 patients with metastatic melanoma who received ICB with or without palliative RT between 2014 and 2018. The melanoma subtypes were classified as follows: chronic sun-damaged (CSD), acral, mucosal, and uveal. The primary endpoint was the objective response rate (ORR).ResultsThe overall ORR was 15%, with 11 complete and eight partial responses. ORRs for CSD, acral/mucosal, and uveal melanomas were 50%, 16.5%, and 0%, respectively (p=0.009). In addition to the subtype, stage at treatment, total tumor burden at treatment, and ICB type were significantly associated with ORR (all p < 0.05). Palliative RT was administered in 44% of patients during the treatment, and it did not affect ORR. Clinical responders to ICB therapy exhibited significantly higher 1-year progression-free and overall survival rates than nonresponders.ConclusionORR for ICB monotherapy in Korean patients with melanoma is relatively modest compared with that in Western patients because the non-CSD subtypes are predominant in the Korean population. Our findings regarding combination therapy with ICB provided a rationale for the initiation of our phase II study (NCT04017897).

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Section: Discussionsupporting

confidence: 89%

Clinical Outcomes of Immune Checkpoint Blocker Therapy for Malignant Melanoma in Korean Patients: Potential Clinical Implications for a Combination Strategy Involving Radiotherapy

et al. 2020

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“…To the best of our knowledge, there has been no report on the combination of dacarbazine and radiotherapy to manage cardiac metastasis of malignant melanoma. It has been reported that the simultaneous combination of dacarbazine and radiotherapy does not increase adverse events significantly [ 15 ]. In cases where immune checkpoint inhibitors cannot be used because of immune-related adverse reactions, the combination therapy of dacarbazine and radiotherapy could serve as a viable therapeutic option for cardiac metastasis.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Late Onset of Cardiac Metastasis of a Melanoma following Nivolumab Immunotherapy

et al. 2022

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In this report, we present a case of cardiac metastasis of a malignant melanoma originating from the nasal cavity and presenting with cardiac tamponade detected during immunotherapy. The patient was a 66-year-old man diagnosed with malignant melanoma of the right nasal cavity 4 years ago. Two years ago, the size of the melanoma increased making it unresectable; therefore, he was treated thrice with a combination therapy of nivolumab and ipilimumab. Subsequently, the treatment was changed to single-agent nivolumab therapy, which was continuously administered for one and a half years. Imaging evaluation conducted every 3 months showed no distant metastasis. General malaise occurred, and the patient visited our department. He was diagnosed to have cardiac tamponade using echocardiography and was admitted to the emergency department of our hospital. He underwent pericardiocentesis. Computed tomography revealed an irregular mass extending from the right atrium to the inferior vena cava, and malignant melanoma metastasis was diagnosed through catheter biopsy and histology. As the tumor was unresectable, radiotherapy (30 Gy/10 fractions) and dacarbazine administration were performed on the right atrial mass, and pericardial effusion improved.

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“…Ten studies [73][74][75][76][77][78][79][80][81][82] analyzed concurrent combined therapy (immunotherapy, chemotherapy, targeted therapy) with SRS ( Table 5). Several histologies were included in these series: melanoma (5), renal carcinoma (1), breast cancer (1), and multiple cancers (3).…”

Section: Combined Therapymentioning

confidence: 99%

Safety of radiosurgery concurrent with systemic therapy (chemotherapy, targeted therapy, and/or immunotherapy) in brain metastases: a systematic review

Borius

Régis

Kalamaridès

et al. 2021

Cancer Metastasis Rev

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Stereotactic radiosurgery (SRS) is a standard option for brain metastases (BM). There is lack of consensus when patients have a systemic treatment, if a washout is necessary. The aim of this review is to analyze the toxicity of SRS when it is concurrent with chemotherapies, immunotherapy, and/or targeted therapies. From Medline and Embase databases, we searched for English literature published up to April 2020 according to the PRISMA guidelines, using for key words the list of the main systemic therapies currently in use And "radiosurgery," "SRS," "GKRS," "Gamma Knife," "toxicity," "ARE," "radiation necrosis," "safety," "brain metastases." Studies reporting safety or toxicity with SRS concurrent with systemic treatment for BM were included. Of 852 abstracts recorded, 77 were included. The main cancers were melanoma, lung, breast, and renal carcinoma. These studies cumulate 6384 patients. The median SRS dose prescription was 20 Gy [12-30] .For some, they compared a concurrent arm with a non-concurrent or a SRS-alone arm. There were no skin toxicities, no clearly increased rate of bleeding, or radiation necrosis with significant clinical impact. SRS combined with systemic therapy appears to be safe, allowing the continuation of treatment when brain SRS is considered.

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Safety assessment of anticancer drugs in association with radiotherapy in metastatic malignant melanoma: a real-life report

Cited by 5 publications

References 43 publications

Clinical Outcomes of Immune Checkpoint Blocker Therapy for Malignant Melanoma in Korean Patients: Potential Clinical Implications for a Combination Strategy Involving Radiotherapy

Clinical Outcomes of Immune Checkpoint Blocker Therapy for Malignant Melanoma in Korean Patients: Potential Clinical Implications for a Combination Strategy Involving Radiotherapy

Late Onset of Cardiac Metastasis of a Melanoma following Nivolumab Immunotherapy

Safety of radiosurgery concurrent with systemic therapy (chemotherapy, targeted therapy, and/or immunotherapy) in brain metastases: a systematic review

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