Long-Term Survival in Patients With Advanced Melanoma

Olivier J van Not; Alfons J M van den Eertwegh; University Groningen; Manja Bloem; John B Haanen; Rozemarijn S van Rijn; Maureen J B Aarts; Franchette W P J van den Berkmortel; Christian U Blank; Marye J Boers-Sonderen; Jan Willem de Groot J W B; Geke A P Hospers; Ellen Kapiteijn; Brenda Leeneman; Piersma D; Marion Stevense-den Boer; Astrid A M van der Veldt; Gerard Vreugdenhil G; Michel W J M Wouters; Willeke A M Blokx; Karijn P M Suijkerbuijk

doi:10.1001/jamanetworkopen.2024.26641

Long-Term Survival in Patients With Advanced Melanoma

Olivier J van Not
, Alfons J M van den Eertwegh
, University Groningen
, Manja Bloem
, John B Haanen
, Rozemarijn S van Rijn
, Maureen J B Aarts
, Franchette W P J van den Berkmortel
, Christian U Blank
, Marye J Boers-Sonderen
, Jan Willem de Groot J W B
, Geke A P Hospers
, Ellen Kapiteijn
, Brenda Leeneman
, Piersma D
, Marion Stevense-den Boer
, Astrid A M van der Veldt
, Gerard Vreugdenhil G
, Michel W J M Wouters
, Willeke A M Blokx

Karijn P M Suijkerbuijk

Research output: Contribution to journal › Article › Academic › peer-review

3 Downloads (Pure)

Abstract

IMPORTANCE: Long-term survival data from clinical trials show that survival curves of patients with advanced melanoma treated with immune checkpoint inhibitors (ICIs) gradually reach a plateau, suggesting that patients have a chance of achieving long-term survival.

OBJECTIVE: To investigate long-term survival in patients with advanced melanoma treated with ICIs outside clinical trials.

DESIGN, SETTING, AND PARTICIPANTS: Cohort study using prospectively collected data from the nationwide Dutch Melanoma Treatment Registry, including patients in the Netherlands with advanced melanoma treated with first-line ICIs from 2012 to 2019. Data were analyzed from January to September 2023.

EXPOSURES: Patients were treated with first-line ipilimumab-nivolumab, antibodies that target programmed cell death (anti-PD-1), or ipilimumab.

MAIN OUTCOMES AND MEASURES: Progression-free survival (PFS) and melanoma-specific survival were analyzed, and a Cox proportional hazards model was used to investigate factors associated with PFS after reaching partial response (PR) or complete response (CR).

RESULTS: A total of 2490 patients treated with first-line ICIs were included (median [IQR] age, 65.0 [55.3-73.0] years; 1561 male patients [62.7%]). Most patients had an Eastern Cooperative Oncology Group Performance Status of 1 or lower (2202 patients [88.5%]) and normal lactate dehydrogenase levels (1715 patients [68.9%]). PFS for all patients was 23.4% (95% CI, 21.7%-25.2%) after 3 years and 19.7% (95% CI, 18.0%-21.4%) after 5 years. Overall survival for all patients was 44.0% (95% CI, 42.1%-46.1%) after 3 years and 35.9% (95% CI, 33.9%-38.0%) after 5 years. Patients with metastases in 3 or more organ sites had a significantly higher hazard of progression after reaching PR or CR (adjusted hazard ratio, 1.37; 95% CI, 1.11-1.69).

CONCLUSIONS AND RELEVANCE: This cohort study of patients with advanced melanoma treated with ICIs in clinical practice showed that their survival reached a plateau, comparable with patients participating in clinical trials. These findings can be used in daily clinical practice to guide long-term surveillance strategies and inform both physicians and patients regarding long-term treatment outcomes.

Original language	English
Article number	e2426641
Journal	JAMA network open
Volume	7
Issue number	8
DOIs	https://doi.org/10.1001/jamanetworkopen.2024.26641
Publication status	Published - 1 Aug 2024

Keywords

Aged
Cohort Studies
Female
Humans
Immune Checkpoint Inhibitors/therapeutic use
Ipilimumab/therapeutic use
Male
Melanoma/drug therapy
Middle Aged
Netherlands/epidemiology
Nivolumab/therapeutic use
Progression-Free Survival
Prospective Studies
Registries
Skin Neoplasms/drug therapy

Access to Document

10.1001/jamanetworkopen.2024.26641Licence: CC BY

van_not_2024_oi_240826_1723563160.15669Final published version, 1.02 MBLicence: CC BY

Cite this

van Not, O. J., van den Eertwegh, A. J. M., Groningen, U., Bloem, M., Haanen, J. B., van Rijn, R. S., Aarts, M. J. B., van den Berkmortel, F. W. P. J., Blank, C. U., Boers-Sonderen, M. J., de Groot J W B, J. W., Hospers, G. A. P., Kapiteijn, E., Leeneman, B., D, P., Stevense-den Boer, M., van der Veldt, A. A. M., Vreugdenhil G, G., Wouters, M. W. J. M., ... Suijkerbuijk, K. P. M. (2024). Long-Term Survival in Patients With Advanced Melanoma. JAMA network open, 7(8), Article e2426641. https://doi.org/10.1001/jamanetworkopen.2024.26641

@article{ce9b059aa9e648ca983a633716a31112,

title = "Long-Term Survival in Patients With Advanced Melanoma",

abstract = "IMPORTANCE: Long-term survival data from clinical trials show that survival curves of patients with advanced melanoma treated with immune checkpoint inhibitors (ICIs) gradually reach a plateau, suggesting that patients have a chance of achieving long-term survival.OBJECTIVE: To investigate long-term survival in patients with advanced melanoma treated with ICIs outside clinical trials.DESIGN, SETTING, AND PARTICIPANTS: Cohort study using prospectively collected data from the nationwide Dutch Melanoma Treatment Registry, including patients in the Netherlands with advanced melanoma treated with first-line ICIs from 2012 to 2019. Data were analyzed from January to September 2023.EXPOSURES: Patients were treated with first-line ipilimumab-nivolumab, antibodies that target programmed cell death (anti-PD-1), or ipilimumab.MAIN OUTCOMES AND MEASURES: Progression-free survival (PFS) and melanoma-specific survival were analyzed, and a Cox proportional hazards model was used to investigate factors associated with PFS after reaching partial response (PR) or complete response (CR).RESULTS: A total of 2490 patients treated with first-line ICIs were included (median [IQR] age, 65.0 [55.3-73.0] years; 1561 male patients [62.7\%]). Most patients had an Eastern Cooperative Oncology Group Performance Status of 1 or lower (2202 patients [88.5\%]) and normal lactate dehydrogenase levels (1715 patients [68.9\%]). PFS for all patients was 23.4\% (95\% CI, 21.7\%-25.2\%) after 3 years and 19.7\% (95\% CI, 18.0\%-21.4\%) after 5 years. Overall survival for all patients was 44.0\% (95\% CI, 42.1\%-46.1\%) after 3 years and 35.9\% (95\% CI, 33.9\%-38.0\%) after 5 years. Patients with metastases in 3 or more organ sites had a significantly higher hazard of progression after reaching PR or CR (adjusted hazard ratio, 1.37; 95\% CI, 1.11-1.69).CONCLUSIONS AND RELEVANCE: This cohort study of patients with advanced melanoma treated with ICIs in clinical practice showed that their survival reached a plateau, comparable with patients participating in clinical trials. These findings can be used in daily clinical practice to guide long-term surveillance strategies and inform both physicians and patients regarding long-term treatment outcomes.",

keywords = "Aged, Cohort Studies, Female, Humans, Immune Checkpoint Inhibitors/therapeutic use, Ipilimumab/therapeutic use, Male, Melanoma/drug therapy, Middle Aged, Netherlands/epidemiology, Nivolumab/therapeutic use, Progression-Free Survival, Prospective Studies, Registries, Skin Neoplasms/drug therapy",

author = "\{van Not\}, \{Olivier J\} and \{van den Eertwegh\}, \{Alfons J M\} and University Groningen and Manja Bloem and Haanen, \{John B\} and \{van Rijn\}, \{Rozemarijn S\} and Aarts, \{Maureen J B\} and \{van den Berkmortel\}, \{Franchette W P J\} and Blank, \{Christian U\} and Boers-Sonderen, \{Marye J\} and \{de Groot J W B\}, \{Jan Willem\} and Hospers, \{Geke A P\} and Ellen Kapiteijn and Brenda Leeneman and Piersma D and \{Stevense-den Boer\}, Marion and \{van der Veldt\}, \{Astrid A M\} and \{Vreugdenhil G\}, Gerard and Wouters, \{Michel W J M\} and Blokx, \{Willeke A M\} and Suijkerbuijk, \{Karijn P M\}",

note = "Publisher Copyright: {\textcopyright} 2024 van Not OJ et al.",

year = "2024",

month = aug,

day = "1",

doi = "10.1001/jamanetworkopen.2024.26641",

language = "English",

volume = "7",

journal = "JAMA network open",

issn = "2574-3805",

publisher = "American Medical Association",

number = "8",

}

van Not, OJ, van den Eertwegh, AJM, Groningen, U, Bloem, M, Haanen, JB, van Rijn, RS, Aarts, MJB, van den Berkmortel, FWPJ, Blank, CU, Boers-Sonderen, MJ, de Groot J W B, JW, Hospers, GAP, Kapiteijn, E, Leeneman, B, D, P, Stevense-den Boer, M, van der Veldt, AAM, Vreugdenhil G, G, Wouters, MWJM, Blokx, WAM & Suijkerbuijk, KPM 2024, 'Long-Term Survival in Patients With Advanced Melanoma', JAMA network open, vol. 7, no. 8, e2426641. https://doi.org/10.1001/jamanetworkopen.2024.26641

TY - JOUR

T1 - Long-Term Survival in Patients With Advanced Melanoma

AU - van Not, Olivier J

AU - van den Eertwegh, Alfons J M

AU - Groningen, University

AU - Bloem, Manja

AU - Haanen, John B

AU - van Rijn, Rozemarijn S

AU - Aarts, Maureen J B

AU - van den Berkmortel, Franchette W P J

AU - Blank, Christian U

AU - Boers-Sonderen, Marye J

AU - de Groot J W B, Jan Willem

AU - Hospers, Geke A P

AU - Kapiteijn, Ellen

AU - Leeneman, Brenda

AU - D, Piersma

AU - Stevense-den Boer, Marion

AU - van der Veldt, Astrid A M

AU - Vreugdenhil G, Gerard

AU - Wouters, Michel W J M

AU - Blokx, Willeke A M

AU - Suijkerbuijk, Karijn P M

PY - 2024/8/1

Y1 - 2024/8/1

N2 - IMPORTANCE: Long-term survival data from clinical trials show that survival curves of patients with advanced melanoma treated with immune checkpoint inhibitors (ICIs) gradually reach a plateau, suggesting that patients have a chance of achieving long-term survival.OBJECTIVE: To investigate long-term survival in patients with advanced melanoma treated with ICIs outside clinical trials.DESIGN, SETTING, AND PARTICIPANTS: Cohort study using prospectively collected data from the nationwide Dutch Melanoma Treatment Registry, including patients in the Netherlands with advanced melanoma treated with first-line ICIs from 2012 to 2019. Data were analyzed from January to September 2023.EXPOSURES: Patients were treated with first-line ipilimumab-nivolumab, antibodies that target programmed cell death (anti-PD-1), or ipilimumab.MAIN OUTCOMES AND MEASURES: Progression-free survival (PFS) and melanoma-specific survival were analyzed, and a Cox proportional hazards model was used to investigate factors associated with PFS after reaching partial response (PR) or complete response (CR).RESULTS: A total of 2490 patients treated with first-line ICIs were included (median [IQR] age, 65.0 [55.3-73.0] years; 1561 male patients [62.7%]). Most patients had an Eastern Cooperative Oncology Group Performance Status of 1 or lower (2202 patients [88.5%]) and normal lactate dehydrogenase levels (1715 patients [68.9%]). PFS for all patients was 23.4% (95% CI, 21.7%-25.2%) after 3 years and 19.7% (95% CI, 18.0%-21.4%) after 5 years. Overall survival for all patients was 44.0% (95% CI, 42.1%-46.1%) after 3 years and 35.9% (95% CI, 33.9%-38.0%) after 5 years. Patients with metastases in 3 or more organ sites had a significantly higher hazard of progression after reaching PR or CR (adjusted hazard ratio, 1.37; 95% CI, 1.11-1.69).CONCLUSIONS AND RELEVANCE: This cohort study of patients with advanced melanoma treated with ICIs in clinical practice showed that their survival reached a plateau, comparable with patients participating in clinical trials. These findings can be used in daily clinical practice to guide long-term surveillance strategies and inform both physicians and patients regarding long-term treatment outcomes.

AB - IMPORTANCE: Long-term survival data from clinical trials show that survival curves of patients with advanced melanoma treated with immune checkpoint inhibitors (ICIs) gradually reach a plateau, suggesting that patients have a chance of achieving long-term survival.OBJECTIVE: To investigate long-term survival in patients with advanced melanoma treated with ICIs outside clinical trials.DESIGN, SETTING, AND PARTICIPANTS: Cohort study using prospectively collected data from the nationwide Dutch Melanoma Treatment Registry, including patients in the Netherlands with advanced melanoma treated with first-line ICIs from 2012 to 2019. Data were analyzed from January to September 2023.EXPOSURES: Patients were treated with first-line ipilimumab-nivolumab, antibodies that target programmed cell death (anti-PD-1), or ipilimumab.MAIN OUTCOMES AND MEASURES: Progression-free survival (PFS) and melanoma-specific survival were analyzed, and a Cox proportional hazards model was used to investigate factors associated with PFS after reaching partial response (PR) or complete response (CR).RESULTS: A total of 2490 patients treated with first-line ICIs were included (median [IQR] age, 65.0 [55.3-73.0] years; 1561 male patients [62.7%]). Most patients had an Eastern Cooperative Oncology Group Performance Status of 1 or lower (2202 patients [88.5%]) and normal lactate dehydrogenase levels (1715 patients [68.9%]). PFS for all patients was 23.4% (95% CI, 21.7%-25.2%) after 3 years and 19.7% (95% CI, 18.0%-21.4%) after 5 years. Overall survival for all patients was 44.0% (95% CI, 42.1%-46.1%) after 3 years and 35.9% (95% CI, 33.9%-38.0%) after 5 years. Patients with metastases in 3 or more organ sites had a significantly higher hazard of progression after reaching PR or CR (adjusted hazard ratio, 1.37; 95% CI, 1.11-1.69).CONCLUSIONS AND RELEVANCE: This cohort study of patients with advanced melanoma treated with ICIs in clinical practice showed that their survival reached a plateau, comparable with patients participating in clinical trials. These findings can be used in daily clinical practice to guide long-term surveillance strategies and inform both physicians and patients regarding long-term treatment outcomes.

KW - Aged

KW - Cohort Studies

KW - Female

KW - Humans

KW - Immune Checkpoint Inhibitors/therapeutic use

KW - Ipilimumab/therapeutic use

KW - Male

KW - Melanoma/drug therapy

KW - Middle Aged

KW - Netherlands/epidemiology

KW - Nivolumab/therapeutic use

KW - Progression-Free Survival

KW - Prospective Studies

KW - Registries

KW - Skin Neoplasms/drug therapy

U2 - 10.1001/jamanetworkopen.2024.26641

DO - 10.1001/jamanetworkopen.2024.26641

M3 - Article

C2 - 39141388

SN - 2574-3805

VL - 7

JO - JAMA network open

JF - JAMA network open

IS - 8

M1 - e2426641

ER -

Long-Term Survival in Patients With Advanced Melanoma

Abstract

Keywords

Access to Document

Fingerprint

Cite this