Found 1 Presentation For Request "1077p"

Melanoma and other skin tumours

1077P - Treatment outcomes in patients (pts) with melanoma brain metastases (MBM) undergoing systemic therapy: A systematic literature review (SLR) and meta-analysis (MA) of real-world evidence (RWE)

Presentation Number
1077P
Speakers
  • Georgina V. Long (Wollstonecraft, NSW, Australia)

Abstract

Background

Immunotherapy (IO) and targeted therapy (TT) have revolutionized the treatment of pts with MBM, but clinical data on their efficacy are scarce. This analysis summarizes available RWE on the systemic treatment outcomes for pts with MBM.

Methods

An SLR of RWE for any systemic treatment in pts with MBM was conducted by searching Embase® and MEDLINE® databases from inception to February 23, 2020, and ASCO, AACR, ESMO, SMR, and EANO proceedings for 2018–2020. Records were screened by 2 investigators according to PICOS criteria. Records that reported OS outcomes on individual IO or TT therapies (with/without stereotactic radiosurgery [SRS]) were included in the MA. Kaplan–Meier (KM) curves for overall survival (OS) were digitized and converted to pseudo-individual pt data using the Guyot algorithm. MAs were performed by pooling KM curves and naive pooling of weighted median OS (mOS). For single-intervention studies, only reported values were used.

Results

A total of 57 publications (pertaining to 56 studies) were included for evidence synthesis. A total of 21 KM curves on 6 interventions and 1371 pts were digitized. mOS from pooled KM curves was numerically longer for nivolumab plus ipilimumab (NIVO + IPI; 20.6 mo; 95% CI, 17.0–22.9) versus other interventions (mOS ranging from 7.1–13.9 mo; table). Similar results were noted with the naive pooling method. Reporting on prior therapies, pt characteristics, and neurological symptoms was inconsistent.

Conclusions

RWE for MBM is scarce and heterogeneous; further research is warranted on optimal treatment for these pts. This SLR and MA suggest a clinical advantage with NIVO + IPI versus other systemic agents in pts with MBM. However, data interpretation is limited by evidence heterogeneity, inconsistent reporting, and small sample sizes. More consistent reporting of pt characteristics and outcomes is needed.

MA results

Treatment Pooled KM curves Weighted estimatesa
No. of KM curves Pooled sample size, n Median OS, mo (95% CI) No. of cohorts Pooled sample size, n Median OS, mo
DAB – – – 1 17 5.6b
DAB/DAB + TMB 1 132 9.5a (6.7–12.4) 1 132 9.5b
VMB 5 395 13.0 (10.9–13.9) 8 439 7.0
VMB + SRS – – – 1 24 11.9b
IPI 5 105 7.1 (5.7–9.3) 5 134 6.4
IPI + SRS 7 143 13.9 (10.7–16.5) 3 72 15.2
IPI + SRS (after IPI) – – – 1 14 6.4b
IPI + SRS (before/during IPI) – – – 1 32 13.8b
NIVO + IPI 2 543 20.6 (17.0–22.9) 1 380 19.0b
NIVO 1 53 12.4a (6.2–NR) 1 53 12.4b

aWeighted by sample size. bAs reported in original publication. CI, confidence interval; DAB, dabrafenib; IPI, ipilimumab; NIVO, nivolumab; NR not reached; TMB, trametinib; VMB, vemurafenib.

Editorial acknowledgement

Editorial assistance was provided by Mark Palangio and Michele Salernitano of Ashfield MedComms, an Ashfield Health company, funded by Bristol Myers Squibb.

Legal entity responsible for the study

Bristol Myers Squibb.

Funding

Bristol Myers Squibb.

Disclosure

G.V. Long: Financial Interests, Personal, Advisory Role: Bristol Myers Squibb; Financial Interests, Personal, Advisory Role: Novartis; Financial Interests, Personal, Advisory Role: Merck MSD; Financial Interests, Personal, Advisory Role: Specialized Therapeutics; Financial Interests, Personal, Advisory Role: Pierre-Fabre; Financial Interests, Personal, Advisory Role: QBiotics; Financial Interests, Personal, Advisory Role: Amgen; Financial Interests, Personal, Advisory Role: Boehringer Ingelheim. H.A. Tawbi: Financial Interests, Personal and Institutional, Other, Consulting fees; research funding to institution: Bristol Myers Squibb; Financial Interests, Personal and Institutional, Other, Consulting fees; research funding to institution: Merck; Financial Interests, Personal and Institutional, Other, Consulting fees; research funding to institution: Novartis; Financial Interests, Personal and Institutional, Other, Consulting fees; research funding to institution: Genentech; Financial Interests, Personal, Other, Consulting fees: Eisai; Financial Interests, Personal, Other, Consulting fees: Iovance; Financial Interests, Institutional, Funding: GlaxoSmithKline; Financial Interests, Institutional, Funding: Celgene. N. Meyer: Financial Interests, Personal and Institutional, Other: Bristol Myers Squibb; Financial Interests, Personal and Institutional, Other: MSD; Financial Interests, Personal, Other: Roche; Financial Interests, Personal, Other: Novartis; Financial Interests, Personal, Other: Pierre Fabre; Financial Interests, Personal, Other: Sanofi; Financial Interests, Personal, Other: Sun Pharma. B. Breznen: Financial Interests, Personal, Other, Contract fees: Evidinno Inc.. C. Vyas: Financial Interests, Personal, Other, Employee; stock ownership: Bristol Myers Squibb. L. Leung: Financial Interests, Personal, Other: Bristol Myers Squibb. A. Moshyk: Financial Interests, Personal, Other, Employee; shareholder: Bristol Myers Squibb. D. Pushkarna: Financial Interests, Personal, Other: Bristol Myers Squibb. P. Thakkar: Financial Interests, Personal, Other, Employee; stock and share ownership: Bristol Myers Squibb. M.S. Fazeli: Financial Interests, Personal, Other: Bristol Myers Squibb. S. Kotapati: Financial Interests, Personal, Full or part-time Employment, Employee stock ownership and benefits: Bristol Myers Squibb. D. Schadendorf: Financial Interests, Personal, Other, Patient fees to institution; Consulting or advisory role; honoraria; travel, accommodations, expenses: Roche/Genentech; Financial Interests, Personal and Institutional, Other, Patient fees and research grant to institution; Consulting or advisory role; honoraria; speakers bureau; travel, accommodations, expenses; research funding: Novartis; Financial Interests, Personal and Institutional, Other, Patient fees and research grant to institution; Consulting or advisory role; honoraria; speakers bureau; travel, accommodations, expenses; research funding: Bristol Myers Squibb; Financial Interests, Personal, Other, Patient fees to institution; Consulting or advisory role; honoraria; travel, accommodations, expenses: Merck Serono; Financial Interests, Personal, Other, Patient fees to institution; Consulting or advisory role; honoraria; speakers bureau; travel, accommodations, expenses: Amgen; Financial Interests, Personal, Other, Consulting or advisory role; honoraria: Immunocore; Financial Interests, Personal, Other, Consulting or advisory role; speakers bureau; honoraria: Incyte; Financial Interests, Personal, Other, Patient fees to institution; Consulting or advisory role; honoraria: 4SC; Financial Interests, Personal, Other, Patient fees to institution; Consulting or advisory role; speakers bureau; honoraria: Pierre Fabre; Financial Interests, Personal, Other, Consulting or advisory role: Mologen; Financial Interests, Personal, Other, Patient fees to institution; Consulting or advisory role: Sanofi/Regeneron; Financial Interests, Personal, Other, Honoraria: Array BioPharma; Financial Interests, Personal, Other, Honoraria: InFlaRx; Financial Interests, Personal, Other, Patient fees to institution; Honoraria: Philogen; Financial Interests, Personal, Other, Patient fees to institution; Honoraria: Regeneron; Financial Interests, Personal, Other, Patient fees to institution; Consulting or advisory role; honoraria; travel, accommodations, expenses: Merck/MSD; Financial Interests, Personal, Other, Honoraria: Sandoz/Hexal; Financial Interests, Personal, Other, Honoraria: Neracare.

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