Effects of an immunosuppressive therapy on the efficacy of immune checkpoint inhibition in metastatic melanoma – an analysis of the prospective skin cancer registry ADOREG

  • Background The impact of immunosuppressive therapy (IST) on immune-checkpoint inhibition (ICI) is unclear. Methods Patients with unresectable advanced melanoma (MM) treated with ICI in the years 2011–2020 were identified from the prospective multicenter German skin cancer registry ADOREG. Patients with IST within 60 days before, or within 30 days after start of ICI were compared to patients without IST. End points were disease control rate (DCR), overall survival (OS) and progression-free survival (PFS) determined by Kaplan-Meier method. Prognostic factors were evaluated in a Cox regression model. Results Of 814 patients treated with ICI, 73 (9%) received concomitant IST, mainly steroids. Patients with brain metastases (BM) received IST more frequently (n = 34/130 patients; 26%), than patients without BM (39/684 patients; 6%). In patients without BM, IST initiated before, but not IST initiated after start of ICI was significantly associated with worse PFS (univariate hazardBackground The impact of immunosuppressive therapy (IST) on immune-checkpoint inhibition (ICI) is unclear. Methods Patients with unresectable advanced melanoma (MM) treated with ICI in the years 2011–2020 were identified from the prospective multicenter German skin cancer registry ADOREG. Patients with IST within 60 days before, or within 30 days after start of ICI were compared to patients without IST. End points were disease control rate (DCR), overall survival (OS) and progression-free survival (PFS) determined by Kaplan-Meier method. Prognostic factors were evaluated in a Cox regression model. Results Of 814 patients treated with ICI, 73 (9%) received concomitant IST, mainly steroids. Patients with brain metastases (BM) received IST more frequently (n = 34/130 patients; 26%), than patients without BM (39/684 patients; 6%). In patients without BM, IST initiated before, but not IST initiated after start of ICI was significantly associated with worse PFS (univariate hazard ratio (HR) 2.59, 95% confidence interval (95%-CI) 1.07–6.28, p = 0.035; multivariate HR 3.48, 95%-CI 1.26–9.6, p = 0.016). There was no association between IST and OS or DCR. In patients with BM, IST initiated before, but not after start of ICI was significantly associated with worse OS (univariate HR 2.06, 95%-CI 1.07–3.95, p = 0.031; multivariate HR 5.91, 95%-CI 1.74–20.14, p = 0.004). There was no association between IST and PFS or DCR. Conclusion Patients receiving IST 60 days before start of ICI showed a tendency to an impaired therapy outcome. IST initiated within 30 days after start of ICI, mainly due to early side effects, did not affect the efficacy of ICI therapy.show moreshow less

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Author:Corinna Kochanek, Catharina Gilde, Lisa Zimmer, Selma Ugurel, Friedegund Meier, Jochen Utikal, Claudia Pföhler, Rudolf Herbst, Sebastian Haferkamp, Julia WelzelORCiDGND, Pia Dücker, Ulrike Leiter, Michael Weichenthal, Imke von Wasielewski, Yenny Angela, Ralf Gutzmer
URN:urn:nbn:de:bvb:384-opus4-1105623
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/110562
ISSN:0959-8049OPAC
Parent Title (English):European Journal of Cancer
Publisher:Elsevier BV
Type:Article
Language:English
Year of first Publication:2024
Publishing Institution:Universität Augsburg
Release Date:2024/01/08
Tag:Cancer Research; Oncology
Volume:198
First Page:113508
DOI:https://doi.org/10.1016/j.ejca.2023.113508
Institutes:Medizinische Fakultät
Medizinische Fakultät / Universitätsklinikum
Medizinische Fakultät / Lehrstuhl für Dermatologie
Nachhaltigkeitsziele
Nachhaltigkeitsziele / Ziel 3 - Gesundheit und Wohlergehen
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):CC-BY 4.0: Creative Commons: Namensnennung (mit Print on Demand)