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2/2025
vol. 29
abstract:
Original paper
Chemotherapy efficacy in advanced melanoma patients after failure of immune checkpoint and BRAF/MEK inhibitors
Bożena Cybulska Stopa
7, 8
,
Grażyna Kamińska Winciorek
10
,
- Department of Medical and Experimental Oncology, Institute of Oncology, Poznan University of Medical Sciences, Poznań, Poland
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznań, Poland
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, Warszawa, Poland
- Department of Clinical Oncology, Clinical Oncology Clinic, Maria Skłodowska-Curie National Research Institute of Oncology, Cracow Branch, Kraków, Poland
- Department of Oncology, Wroclaw Medical University, Wrocław, Poland
- Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology, and Hematology Center, Wrocław, Poland
- Department of Clinical Oncology, Wroclaw Comprehensive Cancer Center, Wrocław, Poland
- Department of Hematology and Oncology, Faculty of Medicine, Wroclaw University of Science and Technology, Wrocław, Poland
- Department of Clinical Oncology, Holy Cross Cancer Center, Kielce, Poland
- Department of Bone Marrow Transplantation and Oncohematology, Skin Cancer and Melanoma Team, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
- Department of Chemotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
- Department of Diagnostics and Cancer Immunology, Greater Poland Cancer Centre, Poznań, Poland
Contemp Oncol (Pozn) 2025; 29 (2): 165–170
Online publish date: 2025/05/09
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Introduction:
Despite the introduction of new therapies for the treatment of advanced melanoma, treatment is ineffective for a certain number of patients. The efficacy of chemotherapy after failure of anti-programmed death receptor (PD-1) immunotherapy alone or combined with anti-cytotoxic T-lymphocyte-associated antigen (CTLA) is not fully understood. It is believed that due to the immunomodulatory effect of cytostatic agents, its efficacy may be greater when applied after the failure of immunotherapy. The aim of this study was to evaluate the efficacy of different chemotherapy regimens after failure of immunotherapy.
Material and methods:
Patients with advanced melanoma after failure of immunotherapy (anti-PD1+/– anti-CTLA-4) and BRAF mutation-targeted therapy with a BRAF/MEK inhibitor were included in a multicenter, retrospective analysis. Patients were treated with one of four chemotherapy regimens: dacarbazine (DTIC); paclitaxel with carboplatin; cisplatin, vinblastine and dacarbazine (CVD) or bleomycin, DTIC, lomustine, vincristine. The objective response rate (ORR), disease control rate (DCR), median progression-free survival (PFS) and overall survival (OS) were compared in study patients.
Results:
One hundred twenty-four patients were included in the study. Objective response rate was 16.88%, DCR was 38.96%, while median PFS and OS were 2.75 [95% CI: 2.25–3.5] and 6 months [95% CI: 4.75–40], respectively. There were no statistically significant differences in ORR, DCR, median PFS, and OS rates between the patients receiving different chemotherapy regimens.
Conclusions:
In advanced melanoma patients after failure of immune-checkpoint inhibitors with or without BRAF/MEK inhibitors, the choice of chemotherapy regimen remains dependent on the patient’s general condition, comorbidities, the need for rapid reduction of tumor masses, and physician and patient preference.
keywords:
immunotherapy, melanoma, metastasis, target therapy, chemotherapy
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