Clinical Outcomes of Immune Checkpoint Blocker Therapy for Malignant Melanoma in Korean Patients: Potential Clinical Implications for a Combination Strategy Involving Radiotherapy

• Published in: Cancer research and treatment 2020, 52(3), , pp.730-738
• Main Authors: Lee, Jeongshim, Chang, Jee Suk, Roh, Mi Ryung, Jung, Minkyu, Lee, Choong-Kun, Oh, Byung Ho, Chung, Kee Yang, Koom, Woong Sub, Shin, Sang Joon
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Female; Follow-Up Studies; Humans; Immune Checkpoint Inhibitors - therapeutic use; Male; Melanoma - drug therapy; Melanoma - mortality; Melanoma - pathology; Middle Aged; Original; Patient Selection; Prognosis; Republic of Korea; Retrospective Studies; Survival Rate; Young Adult; 의학일반
• ISSN: 1598-2998; 2005-9256
• DOI: 10.4143/crt.2019.598

We investigated the clinical efficacy of immune checkpoint blocker (ICB) therapy for metastatic or advanced melanoma in Korean patients. As well, we assessed whether the effects of ICBs can be enhanced by combination therapy with palliative radiotherapy (RT). We retrospectively reviewed the records of 127 patients with metastatic melanoma who received ICB with or without palliative RT between 2014 and 2018. The melanoma subtypes were classified as follows: chronic sun-damaged (CSD), acral, mucosal, and uveal. The primary endpoint was the objective response rate (ORR). The overall ORR was 15%, with 11 complete and eight partial responses. ORRs for CSD, acral/mucosal, and uveal melanomas were 50%, 16.5%, and 0%, respectively (p=0.009). In addition to the subtype, stage at treatment, total tumor burden at treatment, and ICB type were significantly associated with ORR (all p < 0.05). Palliative RT was administered in 44% of patients during the treatment, and it did not affect ORR. Clinical responders to ICB therapy exhibited significantly higher 1-year progression-free and overall survival rates than nonresponders. ORR for ICB monotherapy in Korean patients with melanoma is relatively modest compared with that in Western patients because the non-CSD subtypes are predominant in the Korean population. Our findings regarding combination therapy with ICB provided a rationale for the initiation of our phase II study (NCT04017897).