Abstract
Objective
There is a growing body of evidence that combining radiotherapy with ipilimumab might improve the survival and response rates in patients with metastatic melanoma. However, the patient and treatment variables that predict for improved outcomes have not been well defined.
Methods
We conducted a retrospective analysis of 69 patients treated with ipilimumab and radiotherapy for metastatic melanoma at a single institution from May 2011 to June 2015. Demographic, clinical, and treatment factors were recorded, and end points of interest included infield and global complete response (CR) after the completion of radiation and ipilimumab based on the RECIST criteria (v1.1), and overall survival (OS). A bivariate and multivariate analysis was then performed to assess the relationship between outcomes and patient variables.
Results
In the multivariate analysis, infield CR was significantly associated with completing a full course of ipilimumab, a higher BED, and a smaller size of metastatic area treated. Global CR was significantly associated with increased age and giving radiotherapy to all areas of disease. OS was significantly associated with completing a full course of ipilimumab and a higher BED. Interestingly, after a multivariate analysis, higher BED was associated with an improved infield CR (p = 0.0281) and was not associated with an improved global CR (p = 0.5284) but was marginally associated with improved OS (p = 0.0545).
Conclusion
Our findings suggest that the rate of a global CR is independent of the dose of radiation given, but the rate of infield CR and OS might improve with higher doses.
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Heath Mackley declares that he has no conflict of interest. Jason Liu declares that he has no conflict of interest. Junjia Zhu declares that he has no conflict of interest. Henry Wagner declares that he has no conflict of interest. Giampaolo Talamo declares that he has no conflict of interest. Todd Schell declares that he has no conflict of interest. Colette Pameijir declares that she has no conflict of interest. Rogerio Neves declares that he has no conflict of interest. Bryan Anderson declares that he has no conflict of interest. Kathleen Kokolus declares that she has no conflict of interest. Jeffrey Sivik declares that he has no conflict of interest. Carol Mallon declares that she has no conflict of interest. Kristian Koller declares that he has no conflict of interest. Joseph Drabick declares that he has no conflict of interest.
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Mackley, H.B., Liu, J., Zhu, J. et al. Improved infield response rates and overall survival in patients with metastatic melanoma receiving higher biological equivalent doses of radiation with ipilimumab. J Radiat Oncol 6, 215–223 (2017). https://doi.org/10.1007/s13566-017-0305-8
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DOI: https://doi.org/10.1007/s13566-017-0305-8