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  • [Front Oncol.] Effect of Radiotherapy Combined With Pembrolizumab on Local Tumor Control in Mucosal Melanoma Patients.

    연세의대 / 김현주, 장지석*, 신상준*

  • 출처
    Front Oncol.
  • 등재일
    2019 Sep 4
  • 저널이슈번호
    9:835. doi: 10.3389/fonc.2019.00835. eCollection 2019.
  • 내용

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    Abstract
    Objective: Mucosal melanoma is an aggressive malignancy with a poor response to conventional therapies. The efficacy of radiotherapy (RT), especially combined with immune checkpoint inhibitors (ICIs), for this rare melanoma subtype remains unknown. We investigated the reciprocal effect of RT and ICI on mucosal melanoma patients.

    Materials and Methods: We identified 23 patients with 31 tumors who were treated with RT between July 2008 and February 2017. All patients received RT for primary or metastatic gross tumor mass with a median dose of 4 Gy per fraction (range 1.8-12 Gy). Eleven patients (14 lesions) were treated with RT alone, whereas 12 (17 lesions) were administered pembrolizumab combined with RT (ICI+RT group). The local control (LC) and adverse event (AE) rates were compared between the groups. Eight patients with metastatic mucosal melanoma treated with ICI alone during the same study period were included as a comparison group.

    Results: The median follow-up period was 17.4 (range 3.7-95.2) months. The target lesion control rate at 1-year was significantly higher in the ICI+RT group than in the RT-alone group or ICI-alone group (94.1% vs. 57.1% vs. 25%; P < 0.05). No abscopal effect was observed in our cohort. Treatment-related AEs were not significantly increased in the combined treatment group compared with the RT-alone group (P > 0.05). No grade ≥3 AEs occurred in the ICI+RT group.

    Conclusions: Besides RT acting as an immune adjuvant, ICI might have a radiosensitizing effect and may increase LC without severe toxicity. We have initiated a phase II study to determine the effects of RT in patients with melanoma undergoing anti-PD1 (NCT04017897).

     


    Author information

    Kim HJ1, Chang JS2, Roh MR3, Oh BH4, Chung KY4, Shin SJ5, Koom WS2.
    1
    Department of Radiation Oncology, Gachon University Gil Hospital, Incheon, South Korea.
    2
    Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
    3
    Department of Dermatology, Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
    4
    Department of Dermatology, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
    5
    Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.

  • 키워드
    adverse events; immunotherapy; local control; melanoma; radiotherapy
  • 편집위원

    국내 흑색종 환자에서 면역치료와 방사선치료의 병용이 feasible 하고, 국소제어율 향상의 가능성을 보여줌

    2019-10-30 15:37:22

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