Clinical outcome of patients with metastatic melanoma of unknown primary in the era of novel therapy
© 2021. The Author(s)..
Melanoma of unknown primary (MUP) is considered different from melanoma of known primary (MKP), and it is unclear whether these patients benefit equally from novel therapies. In the current study, characteristics and overall survival (OS) of patients with advanced and metastatic MUP and MKP were compared in the era of novel therapy. Patients were selected from the prospective nation-wide Dutch Melanoma Treatment Registry (DMTR). The following criteria were applied: diagnosis of stage IIIc unresectable or IV cutaneous MKP (cMKP) or MUP between July 2012 and July 2017 and treatment with immune checkpoint inhibition and/or targeted therapy. OS was estimated using the Kaplan-Meier method. The stratified multivariable Cox regression model was used for adjusted analysis. A total of 2706 patients were eligible including 2321 (85.8%) patients with cMKP and 385 (14.2%) with MUP. In comparative analysis, MUP patients more often presented with advanced and metastatic disease at primary diagnosis with poorer performance status, higher LDH, and central nervous system metastases. In crude analysis, median OS of cMKP or MUP patients was 12 months (interquartile range [IQR] 5 - 44) and 14 months (IQR 5 - not reached), respectively (P = 0.278). In adjusted analysis, OS in MUP patients was superior (hazard rate 0.70, 95% confidence interval 0.58-0.85; P < 0.001). As compared to patients with advanced and metastatic cMKP, MUP patients have superior survival in adjusted analysis, but usually present with poorer prognostic characteristics. In crude analysis, OS was comparable indicating that patients with MUP benefit at least equally from treatment with novel therapies.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:70 |
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| Enthalten in: |
Cancer immunology, immunotherapy : CII - 70(2021), 11 vom: 27. Nov., Seite 3123-3135 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Verver, Danielle [VerfasserIn] |
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| Links: |
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| Themen: |
Antineoplastic Agents |
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| Anmerkungen: |
Date Completed 15.10.2021 Date Revised 18.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00262-021-02871-1 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM323305474 |
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| 100 | 1 | |a Verver, Danielle |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical outcome of patients with metastatic melanoma of unknown primary in the era of novel therapy |
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| 500 | |a Date Completed 15.10.2021 | ||
| 500 | |a Date Revised 18.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. The Author(s). | ||
| 520 | |a Melanoma of unknown primary (MUP) is considered different from melanoma of known primary (MKP), and it is unclear whether these patients benefit equally from novel therapies. In the current study, characteristics and overall survival (OS) of patients with advanced and metastatic MUP and MKP were compared in the era of novel therapy. Patients were selected from the prospective nation-wide Dutch Melanoma Treatment Registry (DMTR). The following criteria were applied: diagnosis of stage IIIc unresectable or IV cutaneous MKP (cMKP) or MUP between July 2012 and July 2017 and treatment with immune checkpoint inhibition and/or targeted therapy. OS was estimated using the Kaplan-Meier method. The stratified multivariable Cox regression model was used for adjusted analysis. A total of 2706 patients were eligible including 2321 (85.8%) patients with cMKP and 385 (14.2%) with MUP. In comparative analysis, MUP patients more often presented with advanced and metastatic disease at primary diagnosis with poorer performance status, higher LDH, and central nervous system metastases. In crude analysis, median OS of cMKP or MUP patients was 12 months (interquartile range [IQR] 5 - 44) and 14 months (IQR 5 - not reached), respectively (P = 0.278). In adjusted analysis, OS in MUP patients was superior (hazard rate 0.70, 95% confidence interval 0.58-0.85; P < 0.001). As compared to patients with advanced and metastatic cMKP, MUP patients have superior survival in adjusted analysis, but usually present with poorer prognostic characteristics. In crude analysis, OS was comparable indicating that patients with MUP benefit at least equally from treatment with novel therapies | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Known primary | |
| 650 | 4 | |a Melanoma | |
| 650 | 4 | |a Novel therapy | |
| 650 | 4 | |a Unknown primary | |
| 650 | 7 | |a Antineoplastic Agents |2 NLM | |
| 650 | 7 | |a Immune Checkpoint Inhibitors |2 NLM | |
| 700 | 1 | |a Grünhagen, Dirk J |e verfasserin |4 aut | |
| 700 | 1 | |a van Akkooi, Alexander C J |e verfasserin |4 aut | |
| 700 | 1 | |a Aarts, Maureen J B |e verfasserin |4 aut | |
| 700 | 1 | |a van den Berkmortel, Franchette W P J |e verfasserin |4 aut | |
| 700 | 1 | |a van den Eertwegh, Alfonsus J M |e verfasserin |4 aut | |
| 700 | 1 | |a de Groot, Jan Willem B |e verfasserin |4 aut | |
| 700 | 1 | |a Boers-Sonderen, Marye J |e verfasserin |4 aut | |
| 700 | 1 | |a Haanen, John B A G |e verfasserin |4 aut | |
| 700 | 1 | |a Hospers, Geke A P |e verfasserin |4 aut | |
| 700 | 1 | |a Kapiteijn, Ellen |e verfasserin |4 aut | |
| 700 | 1 | |a Piersma, Djura |e verfasserin |4 aut | |
| 700 | 1 | |a van Rijn, Rozemarijn S |e verfasserin |4 aut | |
| 700 | 1 | |a Suijkerbuijk, Karijn P M |e verfasserin |4 aut | |
| 700 | 1 | |a Tije, Albert J Ten |e verfasserin |4 aut | |
| 700 | 1 | |a Vreugdenhil, Gerard |e verfasserin |4 aut | |
| 700 | 1 | |a Verhoef, Cornelis |e verfasserin |4 aut | |
| 700 | 1 | |a van der Veldt, Astrid A M |e verfasserin |4 aut | |
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