Ipilimumab plus nivolumab for patients with metastatic uveal melanoma: a multicenter, retrospective study

Yana G. Najjar, Kristina Navrazhina, Fei Ding, Roma Bhatia, Katy Tsai, Kelly Abbate, Barbara Durden, Zeynep Eroglu, Shailender Bhatia, Song Park, Akansha Chowdhary, Sunandana Chandra, Jonathan Kennedy, Marc Ernstoff, Pankit Vachhani, Joseph Drabick, Arun Singh, Tan Xu, Jessica Yang, Richard CarvajalDaniel Manson, John M Kirkwood, Justine Cohen, Ryan Sullivan, Douglas Johnson, Pauline Funchain, Alexander Shoushtari

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

BACKGROUND: Uveal melanoma (UM) is the most common intraocular malignancy in adults. In contrast to cutaneous melanoma (CM), there is no standard therapy, and the efficacy and safety of dual checkpoint blockade with nivolumab and ipilimumab is not well defined. METHODS: We conducted a retrospective analysis of patients with metastatic UM (mUM) who received treatment with ipilimumab plus nivolumab across 14 academic medical centers. Toxicity was graded using National Cancer Institute Common Terminology Criteria for Adverse Events V.5.0. Progression-free survival (PFS) and overall survival (OS) were calculated using Kaplan-Meier methodology. RESULTS: 89 eligible patients were identified. 45% had received prior therapy, which included liver directed therapy (29%), immunotherapy (21%), targeted therapy (10%) and radiation (16%). Patients received a median 3 cycles of ipilimumab plus nivolumab. The median follow-up time was 9.2 months. Overall response rate was 11.6%. One patient achieved complete response (1%), 9 patients had partial response (10%), 21 patients had stable disease (24%) and 55 patients had progressive disease (62%). Median OS from treatment initiation was 15 months and median PFS was 2.7 months. Overall, 82 (92%) of patients discontinued treatment, 34 due to toxicity and 27 due to progressive disease. Common immune-related adverse events were colitis/diarrhea (32%), fatigue (23%), rash (21%) and transaminitis (21%). CONCLUSIONS: Dual checkpoint inhibition yielded higher response rates than previous reports of single-agent immunotherapy in patients with mUM, but the efficacy is lower than in metastatic CM. The median OS of 15 months suggests that the rate of clinical benefit may be larger than the modest response rate.

Original languageEnglish (US)
JournalJournal for immunotherapy of cancer
Volume8
Issue number1
DOIs
StatePublished - Jun 1 2020

Keywords

  • immunotherapy
  • melanoma
  • oncology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Molecular Medicine
  • Oncology
  • Pharmacology
  • Cancer Research

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  • Cite this

    Najjar, Y. G., Navrazhina, K., Ding, F., Bhatia, R., Tsai, K., Abbate, K., Durden, B., Eroglu, Z., Bhatia, S., Park, S., Chowdhary, A., Chandra, S., Kennedy, J., Ernstoff, M., Vachhani, P., Drabick, J., Singh, A., Xu, T., Yang, J., ... Shoushtari, A. (2020). Ipilimumab plus nivolumab for patients with metastatic uveal melanoma: a multicenter, retrospective study. Journal for immunotherapy of cancer, 8(1). https://doi.org/10.1136/jitc-2019-000331