Abstract
Treatment of metastatic melanoma remains challenging, despite a variety of new and promising immunotherapeutic and targeted approaches to therapy. New treatment options are still needed to improve long-term tumour control. We present a case series of seven patients with metastatic melanoma who were treated individually with the anti-CD20 antibody rituximab between July 2014 and July 2015. Two of the patients were treated in an adjuvant setting. All patients had already received a variety of treatments. During an induction phase, the administration of four cycles of weekly rituximab 375 mg/m2 body surface area was planned. After imaging, patients with stable disease continued therapy with rituximab 375 mg/m2 body surface area every 4 weeks up to a maximum of 24 weeks. Two patients experienced grade 2 infusion reactions during the first infusion. Otherwise, treatment was well tolerated and there were no grade 3 or 4 side effects. Staging after the induction phase showed stable disease in five patients, and two patients had progressive disease. Median progression-free survival was 6.3 months (95% CI 4.97–7.53), median overall survival was 14.7 months (95% CI 4.52–24.94), and one patient was still alive in December 2016. In conclusion, rituximab might be a therapeutic option for metastatic melanoma. However, further studies on rituximab among larger patient cohorts are warranted. Evaluation of therapy in an adjuvant setting or in combination with other systemic treatment might, therefore, be of particular interest.
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Abbreviations
- BRAF:
-
B-Raf proto-oncogene
- PFS:
-
Progression-free survival
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The authors thank Hazel Davis for English revision.
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JKW analyzed clinical data and prepared the manuscript. MS and CB contributed to data acquisition and revised the manuscript. AHE was involved in manuscript proof-reading and finalization. JCH designed and coordinated the project, performed the immunohistochemical analyses and revised the manuscript. All authors had full access to all reported data and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors take responsibility for the preparation of the manuscript.
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The institutional review board of the Medical Faculty of the University Hospital of Heidelberg (S-454/2015) approved the retrospective institutional patient data analysis. Guidelines from the Declaration of Helsinki were followed.
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All patients gave written informed consent to individual treatment with rituximab. They were informed that therapy with rituximab is experimental and has not been approved for melanoma treatment.
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Winkler, J.K., Schiller, M., Bender, C. et al. Rituximab as a therapeutic option for patients with advanced melanoma. Cancer Immunol Immunother 67, 917–924 (2018). https://doi.org/10.1007/s00262-018-2145-9
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DOI: https://doi.org/10.1007/s00262-018-2145-9