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Hassel, Jessica C. ; Schank, Timo E. ; Smetak, Heiko ; Mühlbauer, Jasmin ; Salzmann, Martin ; Machiraju, Devayani ; Menzer, Christian ; Lang, Kristin ; König, Laila ; Haefner, Matthias F. ; Hülsmeyer, Ingrid ; Kohler, Christian ; Spang, Rainer ; Enk, Alexander ; Debus, Jürgen ; Beckhove, Philipp

Evaluation of radio-immunotherapy sequence on immunological responses and clinical outcomes in patients with melanoma brain metastases (ELEKTRA)

Hassel, Jessica C., Schank, Timo E., Smetak, Heiko, Mühlbauer, Jasmin, Salzmann, Martin, Machiraju, Devayani, Menzer, Christian, Lang, Kristin, König, Laila, Haefner, Matthias F., Hülsmeyer, Ingrid, Kohler, Christian , Spang, Rainer , Enk, Alexander, Debus, Jürgen und Beckhove, Philipp (2022) Evaluation of radio-immunotherapy sequence on immunological responses and clinical outcomes in patients with melanoma brain metastases (ELEKTRA). Oncoimmunology 11 (1), S. 2066609.

Veröffentlichungsdatum dieses Volltextes: 16 Mai 2022 04:42
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.52281


Zusammenfassung

In patients with melanoma brain metastases (MBM), a combination of radiotherapy (RT) with immune checkpoint inhibitors (ICI) is routinely used. However, the best sequence of radio-immunotherapy (RIT) remains unclear. In an exploratory phase 2 trial, MBM patients received RT (stereotactic or whole-brain radiotherapy depending on the number of MBM) combined with ipilimumab (ipi) +/- nivolumab ...

In patients with melanoma brain metastases (MBM), a combination of radiotherapy (RT) with immune checkpoint inhibitors (ICI) is routinely used. However, the best sequence of radio-immunotherapy (RIT) remains unclear. In an exploratory phase 2 trial, MBM patients received RT (stereotactic or whole-brain radiotherapy depending on the number of MBM) combined with ipilimumab (ipi) +/- nivolumab (nivo) in different sequencing (Rad-ICI or ICI-Rad). Comparators arms included patients treated with ipi-free systemic treatment or without RT (in MBM-free patients). The primary endpoints were radiological and immunological responses in the peripheral blood. Secondary endpoints were progression-free survival (PFS) and overall survival (OS). Of 106 screened, 92 patients were included in the study. Multivariate analysis revealed an advantage for patients starting with RT (Rad-ICI) for overall response rate (RR: p = .007; HR: 7.88 (95%CI: 1.76-35.27)) and disease control rate (DCR: p = .036; HR: 6.26 (95%CI: 1.13-34.71)) with a trend for a better PFS (p = .162; HR: 1.64 (95%CI: 0.8-3.3)). After RT plus two cycles of ipi-based ICI in both RIT sequences, increased frequencies of activated CD4, CD8 T cells and an increase in melanoma-specific T cell responses were observed in the peripheral blood. Lasso regression analysis revealed a significant clinical benefit for patients treated with Rad-ICI sequence and immunological features, including high frequencies of memory T cells and activated CD8 T cells in the blood. This study supports increasing evidence that sequencing RT followed by ICI treatment may have better effects on the immunological responses and clinical outcomes in MBM patients.



Beteiligte Einrichtungen


Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftOncoimmunology
Verlag:TAYLOR & FRANCIS INC
Ort der Veröffentlichung:PHILADELPHIA
Band:11
Nummer des Zeitschriftenheftes oder des Kapitels:1
Seitenbereich:S. 2066609
Datum16 April 2022
InstitutionenLeibniz-Institut für Immuntherapie (LIT)
Medizin > Institut für Funktionelle Genomik > Lehrstuhl für Statistische Bioinformatik (Prof. Spang)
Informatik und Data Science > Fachbereich Bioinformatik > Lehrstuhl für Statistische Bioinformatik (Prof. Spang)
Identifikationsnummer
WertTyp
35481285PubMed-ID
10.1080/2162402X.2022.2066609DOI
Klassifikation
NotationArt
Brain Neoplasms/radiotherapyMESH
HumansMESH
Ipilimumab/therapeutic useMESH
Melanoma/drug therapyMESH
Progression-Free SurvivalMESH
RadioimmunotherapyMESH
Stichwörter / KeywordsREGULATORY T-CELLS; STEREOTACTIC RADIOSURGERY; COMBINED NIVOLUMAB; ACQUIRED-RESISTANCE; RADIOTHERAPY; IPILIMUMAB; CANCER; RADIATION; BLOCKADE; SURVIVAL; Melanoma; brain metastases; radiation; immune checkpoint inhibitors; treatment sequence; immune monitoring; biomarkers
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenZum Teil
URN der UB Regensburgurn:nbn:de:bvb:355-epub-522813
Dokumenten-ID52281

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