TY - JOUR
T1 - A Survival Tree of Advanced Melanoma Patients with Brain Metastases Treated with Immune Checkpoint Inhibitors
AU - van Not, Olivier J
AU - Wind, Thijs T
AU - Ismail, Rawa K
AU - Bhattacharya, Arkajyoti
AU - Jalving, Mathilde
AU - Blank, Christian U
AU - Aarts, Maureen J B
AU - van den Berkmortel, Franchette W P J
AU - Boers-Sonderen, Marye J
AU - van den Eertwegh, Alfonsus J M
AU - de Groot, Jan Willem B
AU - Haanen, John B
AU - Kapiteijn, Ellen
AU - Bloem, Manja
AU - Piersma, Djura
AU - van Rijn, Rozemarijn S
AU - Stevense-den Boer, Marion
AU - van der Veldt, Astrid A M
AU - Vreugdenhil, Gerard
AU - Wouters, Michel W J M
AU - Blokx, Willeke A M
AU - Suijkerbuijk, Karijn P M
AU - Fehrmann, Rudolf S N
AU - Hospers, Geke A P
PY - 2023/5/26
Y1 - 2023/5/26
N2 - The efficacy of immune checkpoint inhibitors (ICIs) in patients with advanced melanoma that develop brain metastases (BM) remains unpredictable. In this study, we aimed to identify prognostic factors in patients with melanoma BM who are treated with ICIs. Data from advanced melanoma patients with BM treated with ICIs in any line between 2013 and 2020 were obtained from the Dutch Melanoma Treatment Registry. Patients were included from the time of the treatment of BM with ICIs. Survival tree analysis was performed with clinicopathological parameters as potential classifiers and overall survival (OS) as the response variable. In total, 1278 patients were included. Most patients were treated with ipilimumab-nivolumab combination therapy (45%). The survival tree analysis resulted in 31 subgroups. The median OS ranged from 2.7 months to 35.7 months. The strongest clinical parameter associated with survival in advanced melanoma patients with BM was the serum lactate dehydrogenase (LDH) level. Patients with elevated LDH levels and symptomatic BM had the worst prognosis. The clinicopathological classifiers identified in this study can contribute to optimizing clinical studies and can aid doctors in giving an indication of the patients' survival based on their baseline and disease characteristics.
AB - The efficacy of immune checkpoint inhibitors (ICIs) in patients with advanced melanoma that develop brain metastases (BM) remains unpredictable. In this study, we aimed to identify prognostic factors in patients with melanoma BM who are treated with ICIs. Data from advanced melanoma patients with BM treated with ICIs in any line between 2013 and 2020 were obtained from the Dutch Melanoma Treatment Registry. Patients were included from the time of the treatment of BM with ICIs. Survival tree analysis was performed with clinicopathological parameters as potential classifiers and overall survival (OS) as the response variable. In total, 1278 patients were included. Most patients were treated with ipilimumab-nivolumab combination therapy (45%). The survival tree analysis resulted in 31 subgroups. The median OS ranged from 2.7 months to 35.7 months. The strongest clinical parameter associated with survival in advanced melanoma patients with BM was the serum lactate dehydrogenase (LDH) level. Patients with elevated LDH levels and symptomatic BM had the worst prognosis. The clinicopathological classifiers identified in this study can contribute to optimizing clinical studies and can aid doctors in giving an indication of the patients' survival based on their baseline and disease characteristics.
U2 - 10.3390/cancers15112922
DO - 10.3390/cancers15112922
M3 - Article
C2 - 37296885
SN - 2072-6694
VL - 15
JO - Cancers
JF - Cancers
IS - 11
M1 - 2922
ER -