Immunotherapy and radiotherapy in metastatic uveal melanoma: Results from a single institute study.

Authors

null

Jian Guan

Houston Methodist Cancer Center, Houston, TX

Jian Guan , Bin S. Teh , Amy Schefler , Eric Bernicker

Organizations

Houston Methodist Cancer Center, Houston, TX, Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX, Retina Consultants of Texas, Bellaire, TX

Research Funding

No funding received
None.

Background: Metastatic uveal melanoma carries a poor prognosis, especially for patients who are not eligible for Tebentafusp. Unlike cutaneous melanoma, checkpoint inhibitors have limited effect on uveal melanoma. The observation of Abscopal effect has inspired this study of adding radiotherapy to boost the efficacy of immunotherapy. Methods: We performed a retrospective study in Houston Methodist Hospital to evaluate the efficacy of combining immunotherapy with radiotherapy including either SBRT or Y-90 treatment. Clinical outcomes were determined by assessing best overall response according to the Response Evaluation Criteria in Solid Tumors (version 1.1), progression-free survival(PFS) and overall survival. Results: A total of 8 patients were included for this study, among which one patient had previously progressed on immunotherapy. The median follow-up period was 19 months. The best overall response rate (ORR) and disease control rate (DCR) were 25% and 75% in patients received dual-modality combination treatment (including one complete response and one partial response). The PFS and overall survival in dual-modality combination treatment group were 5.4 months (95% CI, 1.1 to 14.9 months) and 18.7 month (95% CI, 11.1 to 23.9 months), respectively. Fifty percent of patients experienced grade 3-4 treatment-related adverse events. Conclusions: The combination of radiotherapy and immunotherapy is active in metastatic uveal melanoma with sustained response in selected patients. A randomized prospective trial may be required to confirm the benefits of dual-modality combination treatment.

Key baseline demographics and disease characteristics.

TotalN=8
Sex
Female4(50)
Male4(50)
Age, years, median(range)57(49-85)
Eye local therapy
Plaque7(87.5)
Enucleation1(12.5)
Gene Expression Profile
Class 1A1(12.5)
Class 1B1(12.5)
Class 26(75)
Not tested0
PRAME test
Positive4(50)
Negative2(25)
Not tested2(25)
Sites of metastatic disease
Liver only4(50)
Approach of radiotherapy
SBRT(25-40Gy)6(75)
IMRT(4GyX15)1(12.5)
Y901(12.5)
IO agents
Nivolumab and/or Ipilimumab7(87.5)
Pembrolizumab1(12.5)
Prior adjuvant therapy
Sunitinib2(25)
Types of prior therapy in metastatic setting
Immunotherapy1(12.5)
Type of subsequent systemic therapy
Targeted therapy4(50)
Chemotherapy2(25)

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Advanced/Metastatic Disease

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e21507)

DOI

10.1200/JCO.2023.41.16_suppl.e21507

Abstract #

e21507

Abstract Disclosures

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