Using Benchmarks Based on Historical Survival Rates for Screening New Therapies for Stage IV Melanoma Patients

2008 ◽  
Vol 26 (4) ◽  
pp. 517-518 ◽  
Author(s):  
Phyllis A. Gimotty ◽  
DuPont Guerry ◽  
Keith Flaherty
Keyword(s):  
Survival Rates ◽  
Stage Iv ◽  
New Therapies ◽  
Melanoma Patients ◽  
Stage Iv Melanoma

scholarly journals 561 Metastasectomy for Stage IV Melanoma in the Effective Systemic Treatment Era

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M J Corbetta Machado ◽  
R Gourlay ◽  
A Majid ◽  
A Van der Westhuizen
Keyword(s):  
Survival Curve ◽  
Survival Rates ◽  
Stage Iv ◽  
Braf Inhibitors ◽  
Inclusion Criteria ◽  
Mater Hospital ◽  
Disease Characteristics ◽  
Kaplan Meier ◽  
Melanoma Patients ◽  
Stage Iv Melanoma

Abstract Aim Historically, a diagnosis of Stage IV melanoma was a dire one, with low survival rates and ineffective treatment. The only beneficial treatment option was metastasectomy in very selected cases. The recent introduction of the effective systemic therapy agents (EST) (immunotherapy and BRAF inhibitors) dramatically changed this. This research’s aim is to determine if EST + Metastectomy significantly improves OS. And if so, should be considered as the main therapeutic approach to stage IV melanoma patients. Method Single-centre retrospective cohort study from the Melanoma Unit at Calvary Mater Hospital in Australia was conducted, approved by the ethics committee. Inclusion criteria was Stage IV Melanoma patients who received EST from 2009-2019. OS of those who received EST alone are compared to EST + Metastasectomy. The 2 groups were compared retrospectively based on their disease characteristics, using probability score weighting analysis and survival curve. Results This is a preliminary analysis for the first 200 patients, data collection is ongoing. Mean OS is 2 years. Several combinations of immunotherapy treatments were identified. Of the 200 patients, 35% underwent metastasectomy. Mean survival for those who had surgery is 3 years, as oppose to 2 years for those who had EST alone. OS in the Metastasectomy group was higher than those who had EST alone, of 47.1% and 42.3% respectively. The Kaplan Meier curve also shows increase survival in the metastasectomy group, up to year 6 post diagnosis. Conclusions Metastasectomy for stage iv melanoma in the EST era appears to offer a survival benefit in selected patients

scholarly journals Long-term Survival of Stage IV Melanoma Patients Treated with BOLD Combination Chemotherapy and Intermediate-dose Subcutaneous Interferon-alpha

2018 ◽  
Vol 38 (11) ◽  
pp. 6393-6397 ◽  
Author(s):  
KALLE MATTILA ◽  
PIRITA RAANTA ◽  
VALTTERI LAHTELA ◽  
SEPPO PYRHÖNEN ◽  
ILKKA KOSKIVUO ◽  
...  
Keyword(s):  
Interferon Alpha ◽  
Combination Chemotherapy ◽  
Stage Iv ◽  
Term Survival ◽  
Long Term Survival ◽  
Melanoma Patients ◽  
Stage Iv Melanoma ◽  
Intermediate Dose

Circulating Tumor Cells in Stage IV Melanoma Patients

2018 ◽  
Vol 227 (1) ◽  
pp. 116-124 ◽  
Author(s):  
Carolyn S. Hall ◽  
Merrick Ross ◽  
Jessica B. Bowman Bauldry ◽  
Joshua Upshaw ◽  
Mandar G. Karhade ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Stage Iv ◽  
Melanoma Patients ◽  
Stage Iv Melanoma

Abstract 2847: Quantitative assessment of circulating BRAF DNA in stage IV melanoma patients undergoing BRAF inhibitor treatment

2014 ◽  
Author(s):  
David Polsky ◽  
Jyothi Sakuntala Tadepalli ◽  
Gregory Chang ◽  
Nathaniel Fleming ◽  
Yongzhao Shao ◽  
...  
Keyword(s):  
Quantitative Assessment ◽  
Braf Inhibitor ◽  
Stage Iv ◽  
Melanoma Patients ◽  
Inhibitor Treatment ◽  
Stage Iv Melanoma

scholarly journals Combining chemotherapy and autologous peptide‐pulsed dendritic cells provides survival benefit in stage IV melanoma patients

2020 ◽  
Vol 18 (11) ◽  
pp. 1270-1277
Author(s):  
Klaus Eisendle ◽  
Georg Weinlich ◽  
Susanne Ebner ◽  
Markus Forstner ◽  
Daniela Reider ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Survival Benefit ◽  
Stage Iv ◽  
Melanoma Patients ◽  
Stage Iv Melanoma

Monocyte-derived IL-10 Expression Predicts Prognosis of Stage IV Melanoma Patients

2007 ◽  
Vol 30 (8) ◽  
pp. 831-838 ◽  
Author(s):  
Hitoe Torisu-Itakura ◽  
Jonathan H. Lee ◽  
Young Huynh ◽  
Xing Ye ◽  
Richard Essner ◽  
...  
Keyword(s):  
Stage Iv ◽  
Melanoma Patients ◽  
Stage Iv Melanoma

Weekly paclitaxel and carboplatin may be an option for salvage chemotherapy in stage IV melanoma patients

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 7572-7572
Author(s):  
S. G. Holtan ◽  
R. D. Rao ◽  
E. Creagan ◽  
J. Kaur ◽  
H. Pitot ◽  
...  
Keyword(s):  
Stage Iv ◽  
Salvage Chemotherapy ◽  
Weekly Paclitaxel ◽  
Melanoma Patients ◽  
Stage Iv Melanoma

Preoperative peripheral blood lymphocyte/monocyte ratio and survival in patients with resected stage IV melanoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 8600-8600
Author(s):  
Nicole M. Rochet ◽  
Luis F. Porrata ◽  
Lisa A. Kottschade ◽  
Travis Edward Grotz ◽  
Svetomir Markovic
Keyword(s):  
Prognostic Factor ◽  
Proportional Hazards ◽  
Complete Blood Count ◽  
Stage Iv ◽  
Independent Prognostic Factor ◽  
Monocyte Count ◽  
Continuous Variables ◽  
Melanoma Patients ◽  
Chi Square Analysis ◽  
Stage Iv Melanoma

8600 Background: The prognosis of stage IV melanoma patients remains poor. Published results have suggested that components of the complete blood count have significant prognostic value in several malignancies. Among the most studied were the absolute lymphocyte count (ALC), and absolute monocyte count (AMC) on clinical outcomes of patients with lymphoid malignancies. Thus, we sought to investigate if the pre-operative ALC (ALC-PO), AMC (AMC-PO) and ALC/AMC ratio (ALC/AMC-PO) affects the risk of disease recurrence and survival after complete surgical resection of metastatic melanoma. Methods: We studied 66 stage IV, resected melanoma patients followed at Mayo Clinic from 2000 to 2010. Log rank chi-square analysis was used to determine the best cut-off values for each pre-operative variable, while proportional hazards models were used to compared survival. Results: The median follow-up of the cohort was 24 months (range: 2.3 – 117 months). ALC-PO, AMC-PO and ALC/AMC-PO, as continuous variables, were all identified as prognostic factors for both relapse-free survival (RFS) and overall survival (OS). The best cut-off values for ALC-PO, AMC-PO and ALC/AMC-PO were 1.9; 0.62; and 2.05, respectively. Using Kaplan-Meier analysis, patients with an ALC-PO ≥ 1.9 x 109/L experienced superior OS and RFS compared with ALC-PO < 1.9 x 109/L patients [median OS of 58 months vs. 34 months, p < 0.04; median RFS of 14 months vs. 5 months, p < 0.009]. Conversely, a low AMC-PO (<0.62 x 109/L) was associated with better OS and RFS compared with higher AMC-PO (≥ 0.62 x 109/L): [median OS of 47 months vs. 14 months, p < 0.007; median RFS of 9 months vs. 5 months, p < 0.02]. When the ALC-PO and AMC-PO were combined as an ALC/AMC ratio, the group with an ALC/AMC-PO ≥ 2.05 experienced a superior OS and RFS compared to patients with ALC/AMC-PO < 2.05: [median OS of 49 months vs. 12 months, p < 0.0001; median RFS of 10 months vs. 4 months, p < 0.0001]. Multivariate analysis showed ALC/AMC-PO to be an independent prognostic factor for RFS and OS (HR = 0.32, p < 0.003; HR = 0.23, p < 0.002). Conclusions: Our study showed, that ALC/AMC-PO ratio is an independent prognostic factor for RFS and OS in patients undergoing resection of metastatic (stage IV) melanoma.

Survival of melanoma patients with brain metastases treated with ipilimumab combined with stereotactic radiosurgery.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20019-e20019
Author(s):  
Karim Tazi ◽  
Cody Chiuzan ◽  
Keisuke Shirai
Keyword(s):  
Overall Survival ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Performance Status ◽  
Survival Rates ◽  
Stage Iv ◽  
Rank Test ◽  
Group A ◽  
Stage Iv Melanoma

e20019 Background: Historically, melanoma with brain metastases has a poor prognosis and is a major contributor to patient morbidity and mortality. Recently, the use of ipilimumab has improved overall survival in stage IV melanoma; however, the outcome of patients with brain metastases remains unclear. In this retrospective medical record review, we report the outcome of patients with stage IV melanoma with brain metastases treated with ipilimumab and brain stereotactic radiosurgery (SRS). Methods: All patients with metastatic melanoma treated with ipilimumab from April 2010 to March 2012 were identified and stratified by presence (A) or absence (B) of brain metastases. All patients with brain metastases received SRS. Performance status, dates of stage IV diagnosis, brain SRS and cycle 1 of ipilimumab administration were recorded. We used the Disease Specific Graded Prognostic Assessment (DS-GPA) to estimate the predicted survival. Overall survival was defined as time (months) from the date of the stage IV diagnosis and the time of ipilimumab administration to death or last follow-up. Survival curves were estimated using the Kaplan-Meier method, and compared using a two-tailed log-rank test. Results: Twelve of 30 patients treated with ipilimumab had brain metastases. Median age was 66 years. Median DS-GPA score was 3 (estimated mean survival of 8.7 months). Four patients (33%) in group A and 6 patients (33%) in group B died as of last follow-up. Median number of SRS treatment was 1 (1 to 4), and median total treated lesions were 3 (1-14). Median survivals from date of Stage IV for A and B were 29.1 and 32.9 months, respectively (p=0.67). The estimated 2 year survival rates from date of cycle 1 ipilimumab administration for A and B were 58% (95% CI: 32-100%) and 55% (95% CI: 32-93%), respectively. Ten out of 12 patients in group A maintained an ECOG PS of 0-1 as of last follow-up. Conclusions: Survival of patients with melanoma brain metastases treated with ipilimumab combined with SRS may be comparable to patients without brain metastases. Ipilimumab and SRS do not seem to adversely impact quality of life.

Patterns in progression from early stage melanoma to late stage melanoma: Implications for survivorship follow up.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24055-e24055
Author(s):  
Benjamin Switzer ◽  
David James Savage ◽  
Jung Min Song ◽  
Carolyn Stanek ◽  
Pauline Funchain
Keyword(s):  
Disease Progression ◽  
Metastatic Disease ◽  
De Novo ◽  
Early Stage ◽  
Stage Iv ◽  
Symptomatic Disease ◽  
Stage Ia ◽  
Melanoma Patients ◽  
Stage Iv Melanoma

e24055 Background: Despite an encouraging 99% five-year survival in patients diagnosed with early-stage melanoma, a higher proportion of fatal melanomas initially present with thin ( < 1mm) rather than thick ( > 4mm) melanoma.1 Therefore, early-stage melanoma survivorship remains a topic of high interest. We examined a cohort of early-stage melanomas which progressed to stage IV to inform survivorship and risk-stratification approaches in this large, understudied population. Methods: From a retrospective single-center study of 880 consecutive melanoma patients from 2016-2020, we identified new, non- de novo diagnoses of stage IV melanoma which progressed from an initial early-stage (IA-IIA) diagnosis. Descriptive data were collected via chart review on demographics, clinical features, presentation at time of progression, and follow up prior to progression. Results: A total of 50 patients met the inclusion criterion of an initial stage IA-IIA diagnosis with subsequent progression to stage IV melanoma. Primary early stage melanomas were diagnosed an average of 6.1 years prior to metastatic disease progression, with 46% (n = 23) diagnosed within 3 years, 22% (n = 11) between 4-6 years, 12% (n = 6) between 7-10 years, 8% (n = 4) between 10-12 years, and 12% (n = 6) beyond the 12 year mark from their initial early-stage diagnosis. Average age at time of diagnosis was 57.7 (median 60, range 21-68), and 62% (n = 31) were male. The two most common early-stage diagnostic sites were lower extremities (27.5%, n = 14) and back (23.5%, n = 12). The two most common sites of metastatic disease were lung (46%, n = 23) and brain (28%, n = 14). A total of 30% (n = 15) and 34% (n = 17) of this cohort maintained follow up with oncology and dermatology, respectively, prior to their stage IV diagnosis. Symptomatic disease lead to 80% (n = 40) of stage IV diagnoses, while 14% (n = 7) were diagnosed through routine oncologic or dermatologic follow up, and the final 6% were diagnosed incidentally. Conclusions: Early stage melanoma patients who develop stage IV disease exhibit wide ranges in onset of disease progression, thus survivorship plans for this group could include a combination of early provider screening and patient education for later presentations of metastatic disease. Due to relatively common metastatic involvement of the lung and brain, a high suspicion to screen for metastatic disease with symptoms involving these organs may be appropriate.

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