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Published on: February 12, 2017
Rh-endostatin combined with chemotherapy in patients with advanced or recurrent mucosal melanoma: retrospective
Xiaowei Zhang1, Feng Jin2, Shiyu Jiang1
1Department of Medical Oncology, Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Background:
Mucosal melanoma is rare and has distinct clinical and genetic features. Even with advances in targeted and immune therapies, the survival of patients with advanced or recurrent mucosal melanomas remains poor. The standard treatment remains controversial and we conducted this real-world study aimed to explore continuous intravenous recombinant human endostatin (Rh-endostatin) infusion plus chemotherapy in this population in the first-line setting.
Methods:
Overall, 43 patients with advanced or recurrent mucosal melanoma treated at Fudan University Shanghai Cancer Center between April 2017 and August 2020 were retrospectively included. Patients received dacarbazine plus cisplatin or temozolomide plus cisplatin per the investigators' preference. Rh-endostatin (105 mg/m2) was administered with continuous infusion for 168 h (Civ 168 h).
Results:
Of the 43 patients, 72.1% had metastatic disease, and the most common primary site was the gastrointestinal tract (51.2%). The most commonly observed mutations were NRAS (23.1%), BRAF (7.7%) and CKIT mutations (5.1%). An objective response was observed in 12 (30.0%) of the 40 evaluable patients, and disease control was achieved in 31 (77.5%) patients. With a median follow-up of 17.6 months, the median progression-free survival (PFS) and overall survival (OS) were 4.9 and 15.3 months, respectively. Additionally, high lymphocyte-to-monocyte ratio (LMR) (p = 0.023, HR 0.29, 95% CI: 0.10-0.84) and BRAF/KIT/RAS mutation (p = 0.028, HR 0.24, 95% CI: 0.07-0.86) were independently correlated with prolonged OS. Toxicity was manageable overall.
Conclusion:
Continuous Rh-endostatin infusion plus chemotherapy was effective and safe for the treatment of advanced or recurrent mucosal melanoma. High LMR was correlated with favorable PFS and OS in this patient population.
Insights
Continuous intravenous recombinant human endostatin (Rh-endostatin) plus chemotherapy shows promise for advanced mucosal melanoma. This treatment achieved good disease control and manageable toxicity in a real-world study.
Area of Science:
- Oncology
- Medical Research
- Clinical Trials
Background:
- Mucosal melanoma is a rare cancer with poor survival rates, even with current therapies.
- Standard treatment for advanced or recurrent mucosal melanoma remains controversial.
- Novel therapeutic strategies are needed to improve patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of continuous intravenous recombinant human endostatin (Rh-endostatin) infusion plus chemotherapy as a first-line treatment for advanced or recurrent mucosal melanoma.
- To identify potential prognostic factors for improved survival in this patient population.
Main Methods:
- A retrospective study included 43 patients with advanced or recurrent mucosal melanoma.
- Patients received chemotherapy (dacarbazine or temozolomide) combined with cisplatin.
- Continuous intravenous Rh-endostatin (105 mg/m²) was administered over 168 hours.
Main Results:
- Objective response in 30.0% and disease control in 77.5% of evaluable patients.
- Median progression-free survival (PFS) was 4.9 months and overall survival (OS) was 15.3 months.
- High lymphocyte-to-monocyte ratio (LMR) and presence of BRAF/KIT/RAS mutations were independently correlated with prolonged OS.
Conclusions:
- Continuous Rh-endostatin infusion plus chemotherapy is an effective and safe treatment option for advanced or recurrent mucosal melanoma.
- High LMR is a favorable prognostic indicator for PFS and OS in patients with mucosal melanoma.
