The use of pembrolizumab for the treatment of metastatic uveal melanoma
The use of pembrolizumab for the treatment of metastatic uveal melanoma
复制标题
DOI：
10.1097/cmr.0000000000000242
复制
发表时间：
2016-06-01
影响因子：
2.2
通讯作者：
Dronca, Roxana S.
中科院分区：
文献类型：
--
作者：
Kottschade, Lisa A.;McWilliams, Robert R.;Dronca, Roxana S.
葡萄膜黑色素瘤是一种罕见的黑色素瘤，每年每100万人中只有5至7例确诊。葡萄膜来源的转移性黑色素瘤患者对传统疗法的反应率往往较低。在此，我们报告了10例接受pembrolizumab治疗的转移性葡萄膜黑色素瘤（MUM）患者的经验。符合条件的患者年龄大于或等于18岁，患有不可切除的MUM，在先前的易普利姆玛治疗中进展，具有良好的体能状态（东部肿瘤协作组为0或1），以及足够的器官和骨髓功能。患者可能患有中枢神经系统疾病，但需要临床稳定。患者每3周一次静脉注射2 mg/kg帕博利珠单抗30分钟，直至疾病进展、不可接受的毒性或长达2年。在2014年4月至2014年10月期间，我们共使用pembrolizumab治疗了10例MUM患者。中位年龄为65岁，其中70%为女性。截至数据截止日期2015年5月14日，中位无进展生存期为18周（范围3.14-49.3周），4例患者目前仍在接受治疗。在8例可评价患者中，1例完全缓解，2例部分缓解，1例疾病稳定。4例患者疾病进展迅速。毒性符合预期，通常为1/2级。尽管该患者队列较小，但据我们所知，这是第一份关于接受抗PD 1治疗的葡萄膜黑色素瘤患者结局的报告。在缺乏临床试验的情况下，pembrolizumab治疗似乎是MUM患者的可行选择。版权所有（C）2016威科医疗集团All rights reserved.
Uveal melanoma is a rare type of melanoma, with only five to seven cases per one million persons diagnosed each year. Patients with metastatic melanoma of uveal origin tend to have lower response rates on traditional therapies. Herein we report our experience with 10 patients with metastatic uveal melanoma (MUM) who received pembrolizumab. Eligible patients were more than or equal to 18 years old, had unresectable MUM, progressed on prior ipilimumab therapy, had good performance status (Eastern Cooperative Oncology Group of 0 or 1), and adequate organ and marrow function. Patients could have central nervous system disease, but needed to be clinically stable. Patients were treated with 2 mg/kg pembrolizumab intravenously over 30 min every 3 weeks until disease progression, unacceptable toxicity, or for up to 2 years. Between April 2014 and October 2014, we treated a total of 10 patients with MUM with pembrolizumab. Median age was 65 years, with 70% being female. As of the data cutoff date of 14 May 2015, median progression-free survival was 18 weeks (range 3.14-49.3 weeks), with four patients still currently receiving therapy. Of eight evaluable patients, there was one complete response, two partial responses, and one patient with stable disease. Four patients had rapidly progressive disease. Toxicities were as expected and were usually grade 1/2 in nature. Although this cohort of patients was small, to our knowledge this is the first such report of outcomes in uveal melanoma patients being treated with anti-PD1 therapy. In the absence of a clinical trial, treatment with pembrolizumab appears to be a viable option for patients with MUM. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.