Evolving impact of long-term survival results on metastatic melanoma treatment.

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Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_CD4A9414B04C
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Evolving impact of long-term survival results on metastatic melanoma treatment.
Journal
Journal for immunotherapy of cancer
Author(s)
Michielin O., Atkins M.B., Koon H.B., Dummer R., Ascierto P.A.
ISSN
2051-1426 (Electronic)
ISSN-L
2051-1426
Publication state
Published
Issued date
10/2020
Peer-reviewed
Oui
Volume
8
Number
2
Pages
e000948
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Melanoma treatment has been revolutionized over the past decade. Long-term results with immuno-oncology (I-O) agents and targeted therapies are providing evidence of durable survival for a substantial number of patients. These results have prompted consideration of how best to define long-term benefit and cure. Now more than ever, oncologists should be aware of the long-term outcomes demonstrated with these newer agents and their relevance to treatment decision-making. As the first tumor type for which I-O agents were approved, melanoma has served as a model for other diseases. Accordingly, discussions regarding the value and impact of long-term survival data in patients with melanoma may be relevant in the future to other tumor types. Current findings indicate that, depending on the treatment, over 50% of patients with melanoma may gain durable survival benefit. The best survival outcomes are generally observed in patients with favorable prognostic factors, particularly normal baseline lactate dehydrogenase and/or a low volume of disease. Survival curves from melanoma clinical studies show a plateau at 3 to 4 years, suggesting that patients who are alive at the 3-year landmark (especially in cases in which treatment had been stopped) will likely experience prolonged cancer remission. Quality-of-life and mixture-cure modeling data, as well as metrics such as treatment-free survival, are helping to define the value of this long-term survival. In this review, we describe the current treatment landscape for melanoma and discuss the long-term survival data with immunotherapies and targeted therapies, discussing how to best evaluate the value of long-term survival. We propose that some patients might be considered functionally cured if they have responded to treatment and remained treatment-free for at least 2 years without disease progression. Finally, we consider that, while there have been major advances in the treatment of melanoma in the past decade, there remains a need to improve outcomes for the patients with melanoma who do not experience durable survival.
Keywords
CTLA-4 antigen, immunomodulation, immunotherapy, programmed cell death 1 receptor, review
Pubmed
Web of science
Open Access
Yes
Create date
23/10/2020 14:14
Last modification date
15/01/2021 7:11
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