Concurrent multisite radiotherapy, immunotherapy shows metastatic melanoma potential
medwireNews: Early results suggest that combining multisite radiotherapy with immune checkpoint inhibitor therapy can lead to positive outcomes in patients with metastatic melanoma without adding to the toxicity burden.
Henri Montaudié, from Nice University Hospital in France, and colleagues, who report data on 15 patients in JAMA Dermatology, say, however, that “[p]rospective studies with larger samples of patients are needed to confirm the interest of this combination.”
In their cohort, treatment with curative stereotactic ablative radiotherapy or 3-dimensional conformal radiotherapy with a palliative or symptomatic intent was given to a median of two metastatic sites (range 2–8) alongside ipilimumab, nivolumab, or pembrolizumab. This led to 6- and 12-month progression-free survival rates of 71.8% and 46.2%, respectively, while the corresponding rates for overall survival were 77.9% and 58.4%.
Just over a third (34.9%) of the 46 metastatic lesions showed a complete response, while 4.7% had a partial response and 41.9% remained stable.
Over a median 14.1 months of follow-up from radiotherapy, six patients reported no adverse events and among the remaining nine participants, toxicities tended to be largely grade 1 or 2, with the most common being asthenia, pruritus, nausea, vitiligo, and hypothyroidism.
Two patients experienced grade 3 asthenia, and there were no grade 4 or 5 adverse events.
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