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Efficacy and safety of concurrent immunoradiotherapy in patients with metastatic melanoma after progression on nivolumab

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Abstract

Background

The objective of this study was to evaluate the efficacy and safety of concurrent immune checkpoint inhibitor therapy and radiotherapy (immunoradiotherapy) in patients with metastatic melanoma after progression on nivolumab.

Patients and methods

A retrospective review was performed on 16 consecutive patients with metastatic melanoma treated with concurrent immunoradiotherapy after progression on nivolumab. Best responses to immunoradiotherapy were assessed either inside or outside of the radiation fields. The target lesions ratio (the sum of the diameters of the target lesions inside the irradiated fields/all target lesions) was also assessed.

Results

Among the patients, seven received ipilimumab and radiotherapy (Ipi-RT), six received nivolumab and radiotherapy (Nivo-RT), and three sequentially received Ipi-RT and Nivo-RT. The overall response rate (all patients regardless of inside or outside radiation fields) was 30%. The response rate inside the radiation fields was 68.8% for all patients combined. The response rates of Ipi-RT and Nivo-RT inside the radiation fields were 37.5 and 100% (P = 0.03), respectively. Grade 3 adverse events were observed in three patients treated with Ipi-RT. The target lesions ratio was a predictive marker of disease control rate among patients treated with Nivo-RT.

Conclusions

This study showed that concurrent immunoradiotherapy is an option for patients with metastatic melanoma after progression on nivolumab.

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Funding

None of the authors have financial disclosures or funding support.

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Authors and Affiliations

  1. Department of Medical Oncology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Motoo Nomura, Shigemi Matsumoto & Manabu Muto

  2. Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Atsushi Otsuka, Yumi Nonomura & Yo Kaku

  3. Translational Research Department for Skin and Brain Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Atsushi Otsuka

  4. Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Michio Yoshimura

Authors
  1. Motoo Nomura
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  2. Atsushi Otsuka
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  3. Michio Yoshimura
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  4. Yumi Nonomura
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  5. Yo Kaku
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  6. Shigemi Matsumoto
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  7. Manabu Muto
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Corresponding author

Correspondence to Motoo Nomura.

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Conflict of interest

None of the authors have conflicts of interest to declare.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Nomura, M., Otsuka, A., Yoshimura, M. et al. Efficacy and safety of concurrent immunoradiotherapy in patients with metastatic melanoma after progression on nivolumab. Cancer Chemother Pharmacol 81, 823–827 (2018). https://doi.org/10.1007/s00280-018-3557-0

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  • DOI: https://doi.org/10.1007/s00280-018-3557-0

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