Efficacy and toxicity of adjuvant radiotherapy in recurrent melanoma after adjuvant immunotherapy

医学 黑色素瘤 佐剂 肿瘤科 内科学 辅助治疗 易普利姆玛 放射治疗 淋巴结切除术 外科 阶段(地层学) 淋巴结 免疫疗法 癌症 癌症研究 古生物学 生物
作者
Prachi Bhave,Angela Hong,Serigne Lo,Rebecca Johnson,Johanna Mangana,Douglas B. Johnson,Özgecan Dülgar,Zeynep Eroglu,Hui‐Ling Yeoh,Andrew Haydon,Georg Lodde,Elisabeth Livingstone,Adnan Khattak,Katharina C. Kähler,Axel Hausschild,Grant A. McArthur,Alexander M. Menzies,Georgina V. Long,Wei Wang,Matteo S. Carlino
出处
期刊:Journal for ImmunoTherapy of Cancer [BMJ]
卷期号:11 (3): e006629-e006629 被引量:10
标识
DOI:10.1136/jitc-2022-006629
摘要

Background In patients with stage III melanoma, despite surgical resection and adjuvant systemic therapy, locoregional recurrences still occur. The randomized, phase III Trans-Tasman Radiation Oncology Group (TROG) 02.01 trial demonstrated that adjuvant radiotherapy (RT) after complete lymphadenectomy (CLND) halves the incidence of melanoma recurrence within local nodal basins without improving overall survival or quality of life. However, the study was conducted prior to the current era of adjuvant systemic therapies and when CLND was the standard approach for microscopic nodal disease. As such, there is currently no data on the role of adjuvant RT in patients with melanoma who recur during or after adjuvant immunotherapy, including those that may or may not have undergone prior CLND. In this study, we aimed to answer this question. Methods Patients with resected stage III melanoma who received adjuvant anti-programmed cell death protein-1 (PD-1) (±ipilimumab) immunotherapy with a subsequent locoregional (lymph node and/or in-transit metastases) recurrence were retrospectively identified. Multivariable logistic and Cox regression analyses were conducted. Primary outcome was rate of subsequent locoregional recurrence; secondary outcomes were locoregional recurrence-free survival (lr-RFS2) and overall RFS (RFS2) to second recurrence. Results In total, 71 patients were identified: 42 (59%) men, 30 (42%) BRAF V600E mutant, 43 (61%) stage IIIC at diagnosis. Median time to first recurrence was 7 months (1–44), 24 (34%) received adjuvant RT and 47 (66%) did not. Thirty-three patients (46%) developed a second recurrence at a median of 5 months (1–22). The rate of locoregional relapse at second recurrence was lower in those who received adjuvant RT (8%, 2/24) compared with those who did not (36%, 17/47, p=0.01). Adjuvant RT at first recurrence was associated with an improved lr-RFS2 (HR 0.16, p=0.015), with a trend towards an improved RFS2 (HR 0.54, p = 0.072) and no effect on risk of distant recurrence or overall survival. Conclusion This is the first study to investigate the role of adjuvant RT in patients with melanoma with locoregional disease recurrence during or after adjuvant anti-PD-1-based immunotherapy. Adjuvant RT was associated with improved lr-RFS2, but not risk of distant recurrence, demonstrating a likely benefit in locoregional disease control in the modern era. Further prospective studies are required to validate these results.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
干净的寒天发布了新的文献求助200
1秒前
SaiKerry发布了新的文献求助10
1秒前
大喵发布了新的文献求助10
2秒前
wanci应助一颗椰子糖耶采纳,获得10
2秒前
2秒前
忐忑的成仁完成签到,获得积分10
4秒前
乐乐应助_Y_X_L_采纳,获得10
4秒前
4秒前
星辰大海应助漂亮白枫采纳,获得10
8秒前
i3utter发布了新的文献求助10
8秒前
Rondab应助momo采纳,获得10
8秒前
FashionBoy应助大喵采纳,获得10
12秒前
他克莫司发布了新的文献求助100
13秒前
14秒前
14秒前
14秒前
15秒前
赘婿应助zoey采纳,获得10
16秒前
18秒前
烟花应助TT木木采纳,获得10
18秒前
SciGPT应助健忘的水蜜桃采纳,获得10
19秒前
小刘发布了新的文献求助10
20秒前
一直向前发布了新的文献求助10
20秒前
精明怜南发布了新的文献求助10
20秒前
21秒前
李健的粉丝团团长应助11采纳,获得10
21秒前
_Y_X_L_发布了新的文献求助10
22秒前
23秒前
23秒前
图图完成签到 ,获得积分10
23秒前
24秒前
行者完成签到,获得积分10
24秒前
恋雅颖月应助陈桉采纳,获得10
26秒前
26秒前
迷你的颖发布了新的文献求助10
28秒前
28秒前
28秒前
29秒前
情怀应助断章采纳,获得10
29秒前
我睡觉的时候不困完成签到,获得积分10
29秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989797
求助须知:如何正确求助?哪些是违规求助? 3531914
关于积分的说明 11255516
捐赠科研通 3270597
什么是DOI,文献DOI怎么找? 1805008
邀请新用户注册赠送积分活动 882181
科研通“疑难数据库(出版商)”最低求助积分说明 809190