在肢端的黑色素瘤临床活动Ipilimumab:回顾性研究。

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约翰逊DB,彭C,艾布拉姆森RG, F,赵年代,吴克JD, Sosman是的,Carvajal RD, Ariyan CE

在肢端的黑色素瘤临床活动Ipilimumab:回顾性研究。

肿瘤学家。2015年6月,20 (6):648 - 52。doi: 10.1634 / theoncologist.2014 - 0468。2015年5月11日Epub。

PubMed ID

25964307 (在PubMed

]

文摘

背景:Ipilimumab提高总生存期(OS)在先进的黑色素瘤。肢端的黑色素瘤是一种罕见的临床亚型这种疾病与不良预后相关。ipilimumab没有明确的临床活动的先进的肢端的黑色素瘤。方法:我们回顾了人口、治疗的历史,和临床结果肢端的黑色素瘤患者使用ipilimumab治疗从两个学术中心2006年2月到2013年6月。使用Cox比例风险模型,我们评估与操作系统相关的因素。结果:共35肢端的黑色素瘤患者收到ipilimumab。黑色素瘤出现在手掌的表面(n = 28)和指甲下的网站(n = 7);阶段M1c疾病出现在54%和45%升高血清乳酸脱氢酶(LDH)。最好的回应1.1 RECIST标准完成反应1例,局部反应3,和稳定的疾病(SD) 4客观反应率(ORR)为11.4%,临床获益率(奥尔+ SD)在24周的22.9%。中位无进展生存期是2.5个月(95%可信区间[CI]: 2.3 - -2.7个月); median OS was 16.7 months (95% CI: 10.9-22.5 months). Normal LDH and absolute lymphocyte count >/=1,000 at 7 weeks predicted longer OS. Immune-related adverse events (irAEs) were noted in 16 patients including 7 with grade 3/4 irAEs (20%). CONCLUSION: Ipilimumab is clinically active in acral melanoma with similar ORR and OS compared with unselected melanoma populations. Ipilimumab remains a viable therapeutic option for patients with advanced acral melanoma. IMPLICATIONS FOR PRACTICE: Ipilimumab is a commonly used immune therapy that improves survival in metastatic melanoma. The clinical activity of ipilimumab in certain rare melanoma subtypes, such as uveal or mucosal melanomas, is suboptimal. Acral melanoma is another unusual subtype of this disease that arises on the palms, soles, and nailbeds. In this study of 35 patients with acral melanoma from 2 centers, ipilimumab was found to have activity that appears equivalent to unselected melanoma (response rate of 11.4%, median overall survival of 16.7 months). Ipilimumab remains a viable treatment option for this melanoma subpopulation.

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Ipilimumab