Tom 7, Supl. B (2021)
Opis przypadku
Opublikowany online: 2022-04-13
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Długotrwała odpowiedź na leczenie pembrolizumabem u pacjentki z rozpoznaniem czerniaka w stadium uogólnienia z pseudoprogresją
Streszczenie
Pembrolizumab i inne inhibitory punktów kontrolnych są rutynowo stosowane w leczeniu systemowym uogólnionego czerniaka zarówno w leczeniu paliatywnym, jak i adjuwantowym. Immunoterapia jest stosunkowo bezpieczna, ale jako zupełnie inny niż klasyczna chemioterapia rodzaj leczenia stawia nowe wyzwanie dla onkologów. Niniejszy przypadek przedstawia różne problemy kliniczne, takie jak pseudoprogresja, specyficzne dla immunoterapii toksyczności czy kontynuacja leczenia mimo oligoprogresji u pacjentki, która żyje 5 lat od momentu rozpoznania choroby w stadium rozsiewu.
Słowa kluczowe: zerniakimmunoterapialeczenie systemowepembrolizumabpseudoprogresjaoligoprogresja
Referencje
- Atkins MB, Lotze MT, Dutcher JP, et al. High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: analysis of 270 patients treated between 1985 and 1993. J Clin Oncol. 1999; 17(7): 2105–2116.
- Hamid O, Robert C, Daud A, et al. Five-year survival outcomes for patients with advanced melanoma treated with pembrolizumab in KEYNOTE-001. Ann Oncol. 2019; 30(4): 582–588.
- Ribas A, Puzanov I, Dummer R, et al. Pembrolizumab versus investigator-choice chemotherapy for ipilimumab-refractory melanoma (KEYNOTE-002): a randomised, controlled, phase 2 trial. Lancet Oncol. 2015; 16(8): 908–918.
- Robert C, Ribas A, Schachter J, et al. Pembrolizumab versus ipilimumab in advanced melanoma (KEYNOTE-006): post-hoc 5-year results from an open-label, multicentre, randomised, controlled, phase 3 study. Lancet Oncol. 2019; 20(9): 1239–1251.
- Zhang Qi, Huo GW, Zhang HZ, et al. Efficacy of pembrolizumab for advanced/metastatic melanoma: a meta-analysis. Open Med (Wars). 2020; 15(1): 447–456.
- Robert C, Hwu WJ, Hamid O, et al. Long-term safety of pembrolizumab monotherapy and relationship with clinical outcome: A landmark analysis in patients with advanced melanoma. Eur J Cancer. 2021; 144: 182–191.
- Eggermont AMM, Blank CU, Mandala M, et al. Adjuvant Pembrolizumab versus Placebo in Resected Stage III Melanoma. N Engl J Med. 2018; 378(19): 1789–1801.
- Eggermont AMM, Blank CU, Mandalà M, Long GV, Atkinson VG, Dalle S, et al. Adjuvant pembrolizumab versus placebo in resected stage III melanoma (EORTC 1325-MG/KEYNOTE-054): distant metastasis-free survival results from a double-blind, randomised, controlled, phase 3 trial. Lancet Oncol. 2021 Apr;S1470204521000656.
- Luke JJ, Ascierto PA, Carlino MS, et al. KEYNOTE-716: Phase III study of adjuvant pembrolizumab versus placebo in resected high-risk stage II melanoma. Future Oncol. 2020; 16(3): 4429–4438.
- Faries MB, Thompson JF, Cochran AJ, et al. Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma. N Engl J Med. 2017; 376(23): 2211–2222.
- Leiter U, Stadler R, Mauch C, et al. German Dermatologic Cooperative Oncology Group (DeCOG). Complete lymph node dissection versus no dissection in patients with sentinel lymph node biopsy positive melanoma (DeCOG-SLT): a multicentre, randomised, phase 3 trial. Lancet Oncol. 2016; 17(6): 757–767.
- Gershenwald JE, Scolyer RA, Hess KR, et al. for members of the American Joint Committee on Cancer Melanoma Expert Panel and the International Melanoma Database and Discovery Platform. Melanoma staging: Evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017; 67(6): 472–492.
- Long GV, Hauschild A, Santinami M, et al. Adjuvant Dabrafenib plus Trametinib in Stage III BRAF-Mutated Melanoma. N Engl J Med. 2017; 377(19): 1813–1823.
- Michielin O, van Akkooi A, Lorigan P, et al. ESMO consensus conference recommendations on the management of locoregional melanoma: under the auspices of the ESMO Guidelines Committee. Ann Oncol. 2020; 31(11): 1449–1461.
- Long GV, Dummer R, Hamid O, et al. Epacadostat plus pembrolizumab versus placebo plus pembrolizumab in patients with unresectable or metastatic melanoma (ECHO-301/KEYNOTE-252): a phase 3, randomised, double-blind study. Lancet Oncol. 2019; 20(8): 1083–1097.
- Keilholz U, Ascierto PA, Dummer R, et al. ESMO consensus conference recommendations on the management of metastatic melanoma: under the auspices of the ESMO Guidelines Committee. Ann Oncol. 2020; 31(11): 1435–1448.
- Czarnecka AM, Teterycz P, Mariuk-Jarema A, et al. Treatment Sequencing and Clinical Outcomes in BRAF-Positive and BRAF-Negative Unresectable and Metastatic Melanoma Patients Treated with New Systemic Therapies in Routine Practice. Target Oncol. 2019; 14(6): 729–742.
- Andrikopoulou A, Korakiti AM, Apostolidou K, et al. Immune checkpoint inhibitor administration during pregnancy: a case series. ESMO Open. 2021 [Epub ahead of print]; 6(5): 100262.
- Hodi FS, Hwu WJ, Kefford R, et al. Evaluation of Immune-Related Response Criteria and RECIST v1.1 in Patients With Advanced Melanoma Treated With Pembrolizumab. J Clin Oncol. 2016; 34(13): 1510–1517.
- Ahamadi M, Freshwater T, Prohn M, et al. Model-Based Characterization of the Pharmacokinetics of Pembrolizumab: A Humanized Anti-PD-1 Monoclonal Antibody in Advanced Solid Tumors. CPT Pharmacometrics Syst Pharmacol. 2017; 6(1): 49–57.
- Robert C, Ribas A, Wolchok J, et al. Anti-programmed-death-receptor-1 treatment with pembrolizumab in ipilimumab-refractory advanced melanoma: a randomised dose-comparison cohort of a phase 1 trial. The Lancet. 2014; 384(9948): 1109–1117.
- Freshwater T, Kondic A, Ahamadi M, et al. Evaluation of dosing strategy for pembrolizumab for oncology indications. J Immunother Cancer. 2017; 5: 43.
- Lala M, Li TR, de Alwis DP, et al. A six-weekly dosing schedule for pembrolizumab in patients with cancer based on evaluation using modelling and simulation. Eur J Cancer. 2020; 131: 68–75.
- Jacobs C, Rapoport B, Chan S, et al. KEYNOTE-555 Cohort B: Efficacy, safety, and PK of pembrolizumab (pembro) 400 mg every 6 weeks (Q6W) as 1L therapy for advanced melanoma. Journal of Clinical Oncology. 2021; 39(15_suppl): 9541–9541.
- Seegenschmiedt MH, Keilholz L, Altendorf-Hofmann A, et al. Palliative radiotherapy for recurrent and metastatic malignant melanoma: prognostic factors for tumor response and long-term outcome: a 20-year experience. Int J Radiat Oncol Biol Phys. 1999; 44(3): 607–618.
- National Comprehensive Cancer Network. Melanoma: Cutaneous Version 2.2021. https://www.nccn.org/professionals/physician_gls/pdf/cutaneous_melanoma.pdf.
- Overgaard J, Gonzalez Gonzalez D, Hulshof MC, et al. Randomised trial of hyperthermia as adjuvant to radiotherapy for recurrent or metastatic malignant melanoma. European Society for Hyperthermic Oncology. Lancet. 1995; 345(8949): 540–543.
- Spain L, Diem S, Larkin J. Management of toxicities of immune checkpoint inhibitors. Cancer Treat Rev. 2016; 44: 51–60.
- Haanen JB, Carbonnel F, Robert C, et al. ESMO Guidelines Committee. Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017; 28(suppl_4): iv119–iv142.
- Brahmer J, Lacchetti C, Schneider B, et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline. Journal of Clinical Oncology. 2018; 36(17): 1714–1768.
- Robert C, Ribas A, Hamid O, et al. Durable Complete Response After Discontinuation of Pembrolizumab in Patients With Metastatic Melanoma. J Clin Oncol. 2018; 36(17): 1668–1674.
- Jansen YJL, Rozeman EA, Mason R, et al. Discontinuation of anti-PD-1 antibody therapy in the absence of disease progression or treatment limiting toxicity: clinical outcomes in advanced melanoma. Ann Oncol. 2019; 30(7): 1154–1161.
