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Scientific article
Open access
English

Characteristics of long-survivor metastatic melanoma after polychemotherapy and interferon : a retrospective study

Published inSwiss medical weekly, vol. 153, 3504
Publication date2023-12-15
First online date2023-12-15
Abstract

Background: The development of immunotherapy and tyrosine kinase inhibitors dramatically improved the prognosis of metastatic melanoma. Consequently, chemotherapy is now rarely used. Here, we describe the characteristics of long-surviving patients with metastatic melanoma treated with immunochemotherapy.

Material and methods: We retrieved retrospective clinical and pathological data for patients diagnosed with metastatic melanoma between January 1993 and December 2015 who received the CVD-INF (cisplatin, vinblastine, dacarbazine, and interferon α-2b) regimen at the Hôpitaux Universitaires de Genève. We estimated their progression-free survival and overall survival. This ad hoc study's primary aim was to describe the clinical and biological characteristics of long-term survivors, defined as patients surviving more than two years after immunochemotherapy initiation. The spatial distribution pattern of CD8+ T cells (inflamed, excluded, or desert) was immunohistochemically determined.

Results: Ninety patients received CVD-INF. Their median age at metastatic melanoma diagnosis was 55 years (20-75). Their median progression-free survival was 2.8 months, and median overall survival was 7.2 months. Eleven (12%) patients were long-term survivors. In multivariate analysis, central nervous system metastases (hazard ratio [HR]: 2.66; 95% confidence interval [CI]: 1.43-4.95; p = 0.001), multiple metastases (HR: 1.82; 95% CI: 1.01-3.29; p = 0.047), and elevated lactate dehydrogenase (LDH) (HR: 1.92; 95% CI: 1.12-3.30; p = 0.016) were independently associated with shorter survival. Most long-survivors (6/8; 75%) had a tumour-inflamed pattern compared to 25% of non-long survivors (5/20; Fisher's test p = 0.030).

Conclusions: A subset of patients with metastatic melanoma and a tumour-inflamed phenotype treated with CVD-INF survived over two years. Factors associated with prolonged survival are consistent with those previously reported in metastatic melanoma.

eng
Keywords
  • Humans
  • Young Adult
  • Adult
  • Middle Aged
  • Aged
  • Melanoma / drug therapy
  • Retrospective Studies
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Treatment Outcome
  • Interleukin-2
  • Cardiovascular Diseases
  • Skin Neoplasms / drug therapy
Citation (ISO format)
PY, Céline et al. Characteristics of long-survivor metastatic melanoma after polychemotherapy and interferon : a retrospective study. In: Swiss medical weekly, 2023, vol. 153, p. 3504. doi: 10.57187/s.3504
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Identifiers
ISSN of the journal1424-3997
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