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A 3D Organotypic Melanoma Spheroid Skin Model
Published on: May 18, 2018
Clinical features and response to systemic therapy in NRAS-mutant Chinese melanoma patients
Jiuhong Wang1,2, Hang Jiang1,3,4, Fuxue Huang1,5
1Biotherapy Center, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.
Purpose:
The prognosis of patients with NRAS-mutant melanoma is rather poor. Immunotherapy and targeted therapy have revolutionized anti-tumor therapy, especially for melanoma. In this study, we retrospectively summarized the real-world experience of systematic treatment for NRAS-mutant melanoma patients in this new era.
Patients And Methods:
The respective cohort included NRAS-mutant melanoma patients with metastatic or unresectable disease of Sun Yat-sen University Cancer Center (SYSUCC) from January 2018 to July 2022. The data about the clinical features and impact for systemic therapy of NRAS-mutant patients were collected and analyzed.
Results:
At data cutoff, 44 patients (19, 11, and 14 for acral, cutaneous, and mucosal ones, respectively) with NRAS-mutant were assessed. In addition, the median time of follow-up was 22.0 months. The immunotherapy-based combined treatment not only significantly improved the progression-free survival (PFS) (P = 0.006, HR 0.322), but was also accompanied by a higher objective response rate (ORR) (18.2%), disease control rate (DCR) (72.7%) than those of cytotoxic therapy or immunotherapy alone for advanced patients as first-line treatment. Nab-paclitaxel combined with anti-PD-1 inhibitor tended to produce better clinical benefit for the first-line treatment, especially for patients with acral melanoma. In addition, the tyrosine kinase inhibitor (TKI) combined with anti-PD-1 inhibitor also seemed to provide longer duration of response (DOR) for some patients. But combined therapy did not prolong the overall survival (OS) of NRAS-mutant patients. The combined therapy was well tolerated. Most adverse events were moderate and controllable.
Conclusion:
In conclusion, PD-1 inhibitor-based combined therapy increased clinical benefit for advanced patients with NRAS-mutant melanoma.
Insights
Combined immunotherapy improved progression-free survival and response rates in NRAS-mutant melanoma patients. This PD-1 inhibitor-based therapy offers clinical benefit for advanced disease, though overall survival was not prolonged.
Area of Science:
- Oncology
- Dermatology
- Immunotherapy
Background:
- NRAS-mutant melanoma historically has a poor prognosis.
- Immunotherapy and targeted therapies have transformed melanoma treatment.
- Real-world data on advanced NRAS-mutant melanoma treatments are crucial.
Purpose of the Study:
- To evaluate the real-world effectiveness of systematic treatments for NRAS-mutant melanoma.
- To analyze the impact of combined immunotherapy and targeted therapy in this patient population.
Main Methods:
- Retrospective analysis of 44 NRAS-mutant melanoma patients treated at SYSUCC (Jan 2018-July 2022).
- Patients had metastatic or unresectable disease.
- Data on clinical features and treatment outcomes were collected and analyzed.
Main Results:
- Immunotherapy-based combined treatment significantly improved progression-free survival (PFS) and objective response rate (ORR).
- Combined therapy showed higher disease control rates (DCR) compared to single-agent treatments.
- Nab-paclitaxel or TKI combined with anti-PD-1 inhibitor showed promise, particularly for acral melanoma, but did not extend overall survival (OS).
- Combined therapies were generally well-tolerated with manageable adverse events.
Conclusions:
- PD-1 inhibitor-based combined therapy enhances clinical benefit for advanced NRAS-mutant melanoma.
- This approach improves PFS and ORR in patients with NRAS-mutant melanoma.
- Further research may explore optimizing combined strategies for improved overall survival.
