| Title | Chemotherapy combined with antiangiogenic drugs as salvage therapy in advanced melanoma patients progressing on PD-1 immunotherapy |
| Authors | Wang, Xuan Xu, Weiran Chi, Zhihong Si, Lu Sheng, Xinan Kong, Yan Zhou, Li Mao, Lili Lian, Bin Tang, Bixia Yan, Xieqiao Bai, Xue Cui, Chuanliang Guo, Jun |
| Affiliation | Peking Univ Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Dept Renal Canc & Melanoma, Minist Educ Beijing, 52 Fucheng Rd, Beijing 100142, Peoples R China |
| Keywords | IMMUNE-CHECKPOINT BLOCKADE NAB-PACLITAXEL LYMPHOCYTE RATIO NAIVE PATIENTS CANCER NEUTROPHIL PROGNOSIS PLATELET APATINIB TRIAL |
| Issue Date | Jan-2021 |
| Publisher | TRANSLATIONAL ONCOLOGY |
| Abstract | Background: This study aimed to evaluate the effect of salvage therapy with nab-paclitaxel (nab-p) or temozolomide (TMZ) combined with antiangiogenic drugs in programmed death 1 (PD-1) inhibitor-resistant patients with unresectable metastatic melanoma. Methods: We conducted a retrospective review of 69 metastatic melanoma patients who received nab-p or TMZ combined with antiangiogenic drugs after developing PD-1 inhibitor resistance and were treated at the Beijing Cancer Hospital between 2016 and 2019. The disease control rate (c-DCR) and progression-free survival (c-PFS) of salvage CA (chemotherapy combined with antiangiogenic drugs) regimens were investigated. Univariate and multivariate analyses were performed to evaluate the clinical pathological factors affecting the outcomes. Then, a nomogram was formulated to predict the probability of 3-month and 6-month c-PFS based on the multivariate analysis results. Results: The c-DCR was 63.8%, and the median c-PFS was 3.0 months. In the univariate analysis, factors associated with the c-DCR were included the melanoma subtype, baseline platelet-to-lymphocyte ratio (PLR) and best response status to PD-1 inhibitors. Factors influencing c-PFS included age, baseline lactic dehydrogenase, PLR, neutrophil-to-lymphocyte ratio (NLR), PFS duration of anti-PD-1 therapy (p-PFS), and the best response and progression pattern of PD-1 inhibitors. In the multivariate analysis, age < 65 years, heterogeneous progression pattern and baseline PLR < 200 were significantly associated with improved c-PFS. The concordance index (C-index) of the nomogram was equal to 0.65 (95% CI 0.566-0.734). Conclusions: CA regimens demonstrated promising effects in PD-1 inhibitor-resistant patients. The nomogram could be a valuable predictive module for salvage therapy choice in PD-1 inhibitor-resistant patients. |
| URI | http://hdl.handle.net/20.500.11897/621884 |
| ISSN | 1936-5233 |
| DOI | 10.1016/j.tranon.2020.100949 |
| Indexed | SCI(E) |
| Appears in Collections: | 北京肿瘤医院 |
