Meta-analysis in metastatic uveal melanoma to determine progression free and overall survival benchmarks: an international rare cancers initiative (IRCI) ocular melanoma study.

Details

Serval ID
serval:BIB_BD137DAA9150
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Meta-analysis in metastatic uveal melanoma to determine progression free and overall survival benchmarks: an international rare cancers initiative (IRCI) ocular melanoma study.
Journal
Annals of oncology
Author(s)
Khoja L., Atenafu E.G., Suciu S., Leyvraz S., Sato T., Marshall E., Keilholz U., Zimmer L., Patel S.P., Piperno-Neumann S., Piulats J., Kivelä T.T., Pfoehler C., Bhatia S., Huppert P., Van Iersel LBJ, De Vries IJM, Penel N., Vogl T., Cheng T., Fiorentini G., Mouriaux F., Tarhini A., Patel P.M., Carvajal R., Joshua A.M.
ISSN
1569-8041 (Electronic)
ISSN-L
0923-7534
Publication state
Published
Issued date
01/08/2019
Peer-reviewed
Oui
Volume
30
Number
8
Pages
1370-1380
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis
Publication Status: ppublish
Abstract
Despite the completion of numerous phase II studies, a standard of care treatment has yet to be defined for metastatic uveal melanoma (mUM). To determine benchmarks of progression free survival (PFS) and overall survival (OS), we carried out a meta-analysis using individual patient level trial data.
Individual patient variables and survival outcomes were requested from 29 trials published from 2000 to 2016. Univariable and multivariable analysis were carried out for prognostic factors. The variability between trial arms and between therapeutic agents on PFS and OS was investigated.
OS data were available for 912 patients. The median PFS was 3.3 months (95% CI 2.9-3.6) and 6-month PFS rate was 27% (95% CI 24-30). Univariable analysis showed male sex, elevated (i.e. > versus ≤ upper limit of normal) lactate dehydrogenase (LDH), elevated alkaline phosphatase (ALP) and diameter of the largest liver metastasis (≥3 cm versus <3 cm) to be substantially associated with shorter PFS. Multivariable analysis showed male sex, elevated LDH and elevated ALP were substantially associated with shorter PFS. The most substantial factors associated with 6-month PFS rate, on both univariable and multivariable analysis were elevated LDH and ALP. The median OS was 10.2 months (95% CI 9.5-11.0) and 1 year OS was 43% (95% CI 40-47). The most substantial prognostic factors for shorter OS by univariable and multivariable analysis were elevated LDH and elevated ALP. Patients treated with liver directed treatments had statistically significant longer PFS and OS.
Benchmarks of 6-month PFS and 1-year OS rates were determined accounting for prognostic factors. These may be used to facilitate future trial design and stratification in mUM.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Alkaline Phosphatase/blood, Benchmarking, Clinical Trials as Topic/standards, Datasets as Topic, Female, Humans, Kaplan-Meier Estimate, L-Lactate Dehydrogenase/blood, Liver Neoplasms/blood, Liver Neoplasms/drug therapy, Liver Neoplasms/mortality, Liver Neoplasms/secondary, Male, Melanoma/blood, Melanoma/drug therapy, Melanoma/mortality, Melanoma/pathology, Middle Aged, Prognosis, Progression-Free Survival, Prospective Studies, Research Design/statistics & numerical data, Sex Factors, Time Factors, Uveal Neoplasms/blood, Uveal Neoplasms/drug therapy, Uveal Neoplasms/mortality, Uveal Neoplasms/pathology, Young Adult, meta-analysis, survival benchmarks, trial design, uveal melanoma
Pubmed
Web of science
Open Access
Yes
Create date
18/06/2019 16:04
Last modification date
20/06/2020 5:18
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