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Monica Oxenreiter, Anne Marie Lane, Justine V Cohen, Ryan J Sullivan, Ivana K Kim, Evangelos S Gragoudas; Efficacy of immune checkpoint inhibitors for treating uveal melanoma metastases. Invest. Ophthalmol. Vis. Sci. 2019;60(9):742.
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To compare survival in patients with metastatic uveal melanoma treated with immune checkpoint inhibitors to patients who received other therapies or no treatment.
We identified 98 patients treated with proton radiation for uveal melanoma in the Ocular Melanoma Center at Massachusetts Eye and Ear who were subsequently diagnosed with metastasis from January 2010 through May 2018 and followed through August 2018. Survival time after metastasis diagnosis was compared between patients who received antibodies to programmed cell death protein 1 (anti-PD-1) (n=13), cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4) (n=27), or combination therapy (n=4) and patients who received other types of treatment (n=42) or no therapy (n=13).
Mean age of untreated patients was 69.8 years at the time of metastasis diagnosis, compared to 62.6 years for patients receiving anti-PD-1 or anti-CTLA-4; this difference was not significant (P=.22). Gender was not associated with treatment status (40% males in each group). Median time from metastasis diagnosis to death in untreated patients was 2.7 months, compared to 11.1 months and 8.0 months for patients receiving anti-PD-1 (P=.025) and anti-CTLA-4 therapy (P=.002) respectively. 13% of immunotherapy was received as part of a clinical trial. Survival time for patients receiving other therapies was 7.9 months, similar to that of patients undergoing anti-PD-1 or anti-CTLA-4 therapy (P=.37). Hepatic-only metastases occurred in 70% of patients; only 3% of metastases did not involve the liver. Of 19 living patients, 8 were receiving anti-CTLA-4 or anti-PD-1 therapy. Two patients receiving combination therapy have had extended survival with hepatic metastases (follow-up time: 31.3 and 73.1 months).
No meaningful improvement in survival was observed in this cohort of patients with metastatic uveal melanoma treated with anti-PD-1 or anti-CTLA-4 therapy compared to other treatments. These data are consistent with our previous findings, indicating lack of progress in improving survival in patients with uveal melanoma metastasis. Further research, including controlled clinical trials, is needed to develop and evaluate newer therapies.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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