Br J Cancer: ICI pretreatment with immune checkpoint inhibitor improves the efficacy of dacarbazine in the treatment of metastatic melanoma

Previous studies have shown that new therapies such as immune checkpoint inhibitors (ICI) and targeted therapies can greatly improve the survival rate of patients with advanced melanoma
.

The targeted therapy strategy using BRAF and MEK inhibitors has the advantage of inducing rapid response, while the use of anti-CTLA-4 (cytotoxic T lymphocyte antigen 4, ipilimumab) and anti-PD-1 (programmed cell death protein 1, nivolumab, Pembrolizumab) ICI monoclonal antibody (mAb) can induce a durable therapeutic response

Previous studies have shown that new therapies such as immune checkpoint inhibitors (ICI) and targeted therapies can greatly improve the survival rate of patients with advanced melanoma

Since BRAF+MEK inhibitors show similar efficacy in first-line and second-line treatment, while anti-PD-1 mAb has lower efficacy in second-line treatment, ICI is currently recommended for all BRAF wild-type and most BRAF V600 mutant melanomas First-line treatment for patients
.

Therefore, ICI is currently recommended as the first-line treatment for all BRAF wild-type and most BRAF V600 mutant melanoma patients
.

Therefore, ICI is currently recommended as the first-line treatment for all BRAF wild-type and most BRAF V600 mutant melanoma patients

However, a large proportion of patients will develop disease progression after treatment: targeted therapy, pembrolizumab monotherapy and nivolumab combined with ipilimumab for 5 years The overall survival rate (OS) was 34%, 39%, and 52%, respectively
.

Despite the low efficacy, dacarbazine chemotherapy is still an option for patients with metastatic melanoma after ICI± targeted therapy fails
.

Some previous observational studies have shown that chemotherapy has improved the efficacy of melanoma or lung cancer patients who have previously received ICI treatment

Research flow chart

Research flow chart

This retrospective study collected data on patients with advanced melanoma without brain metastases who received dacarbazine at the skin cancer center from June 2006 to September 2019
.

The primary endpoint of the study is progression-free survival (PFS), and the secondary endpoints are the overall response rate (ORR) of dacarbazine, the patient's overall survival (OS), and the safety of the drug

The primary endpoint of the study is progression-free survival (PFS), and the secondary endpoints are the overall response rate (ORR) of dacarbazine, the patient's overall survival (OS), and the safety of the drug

Progression-free survival of patients treated with dacarbazine

Progression-free survival of patients treated with dacarbazine

All in all, the results of the study found that in patients pretreated with ICI, dacarbazine provides short-term benefits to patients with advanced advanced disease, and it can be used as an alternative before considering the best supportive treatment
.

Among patients pre-treated with ICI, dacarbazine provides short-term benefits to patients with advanced advanced disease, and it can be used as an alternative before considering the best supportive treatment
.

Among patients pre-treated with ICI, dacarbazine provides short-term benefits to patients with advanced advanced disease, and it can be used as an alternative before considering the best supportive treatment

Impact of prior treatment with immune checkpoint inhibitors on dacarbazine efficacy in metastatic melanoma.

Leave a message here