Sarcoma and Cutaneous Tumors

SS 20 - Sarcoma and Cutaneous Tumors

156 - Concurrent Radiation Therapy for Patients With Metastatic Melanoma and Receiving Anti-Programmed-Death 1 Therapy: A Retrospective Monocentric Study on 141 Patients

Tuesday, October 23
8:25 AM - 8:35 AM
Location: Room 007 A/B

Concurrent Radiation Therapy for Patients With Metastatic Melanoma and Receiving Anti-Programmed-Death 1 Therapy: A Retrospective Monocentric Study on 141 Patients
V. Atallah, F. Amestoy, E. Gerard, N. Leduc, A. Huchet, M. Beylot-Barry, C. Dupin, S. Prey, L. Dousset, R. Trouette, N. Ouabrache, O. Maillot, M. Martin, P. Gillon, C. Dutriaux, and V. Vendrely; University Hospital of Bordeaux, Bordeaux, France

Purpose/Objective(s): A combination of immune-checkpoint inhibitors and radiation therapy (RT) represents a promising therapeutic strategy in part mediated by the abscopal effect, but clinical experience related to this combination remains scarce.

Materials/Methods: Clinical data and patterns of treatment were retrospectively collected from all consecutive patients with metastatic melanoma non-BRAF mutated and receiving programmed-death 1 (PD-1) immune-checkpoint inhibitors as a first-line therapy exclusively. Survival data and acute and delayed toxicities “in-field” but also “out-field” (graded according to Common Terminology Criteria for Adverse Events, v 4.3) were compared between patients receiving concurrent RT (CIR) or no concurrent irradiation (NCIR). Patients who received RT before immunotherapy were secondly pooled in the analysis.

Results: One hundred and forty-five patients received anti-PD-1 immunotherapy (pembrolizumab [n=114] or nivolumab [n=31]) between February 2013 and November 2017 at our institution. Among these, 15.8% (n=23) received RT before immunotherapy (at least four weeks before immunotherapy) and 17.2% (n=25) received RT concurrently to immunotherapy. Twenty-six % (n=38) received RT both before and/or concurrently to immunotherapy (RT group). RT schedules were heterogeneous. After a 9.2 months median follow-up, median Progression-free survival (PFS) after initiation of immunotherapy for the NCIR group was 12.1 months versus 11.6 months for the CIR group (P=0.41). Overall Survival (OS) was also non significant between these groups (P=0.12). For RT group (n=38), median PFS were 10.5 months compare to 13.0 months for unirradiated patients (P= 0.68). ). OS was also non significant between RT Group and unirradiated patients (P=0.29). Acute and late “in-field” or “out-of-field” immunologic toxicity profiles were similar in the two groups.

Conclusion: Despite the homogeneity of our series (we selected exclusively all patients receiving PD-1 immune checkpoint inhibitors as first-line therapy), we failed to show that combination of RT and anti-PD-1 immunotherapy increase PFS or OS. These results could be explained by the heterogeneity of the RT schedules in our series. However, combination of RT and anti-PD-1 were well tolerated and did not increase toxicities rates within and outside the irradiated field.

Author Disclosure: V. Atallah: None. E. Gerard: None. N. Leduc: None. M. Beylot-Barry: None. S. Prey: None. R. Trouette: None. N. Ouabrache: None.

Vincent Atallah, MD

Disclosure:
No relationships to disclose.

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156 - Concurrent Radiation Therapy for Patients With Metastatic Melanoma and Receiving Anti-Programmed-Death 1 Therapy: A Retrospective Monocentric Study on 141 Patients



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