Shortened progression free and overall survival to immune-checkpoint inhibitors in BRAF-, RAS- and NF1- (“Triple”) wild type melanomas

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Philipp Jansen - , Universität Duisburg-Essen, Universität Bonn (Autor:in)
  • Wolfgang Galetzka - , Universität Duisburg-Essen (Autor:in)
  • Georg C. Lodde - , Universität Duisburg-Essen (Autor:in)
  • Fabian Standl - , Universität Duisburg-Essen (Autor:in)
  • Anne Zaremba - , Universität Duisburg-Essen (Autor:in)
  • Rudolf Herbst - , Fresenius AG (Autor:in)
  • Patrick Terheyden - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Jochen Utikal - , Universität Heidelberg (Autor:in)
  • Claudia Pföhler - , Universität des Saarlandes (Autor:in)
  • Jens Ulrich - , Otto-von-Guericke-Universität Magdeburg (Autor:in)
  • Alexander Kreuter - , Universität Witten/Herdecke (Autor:in)
  • Peter Mohr - , Elbeklinikum Stade/Buxtehude (Autor:in)
  • Ralf Gutzmer - , Ruhr-Universität Bochum (Autor:in)
  • Friedegund Meier - , Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Edgar Dippel - , Klinikum Ludwigshafen (Autor:in)
  • Michael Weichenthal - , Universitätsklinikum Schleswig-Holstein Campus Kiel (Autor:in)
  • Jan Malte Placke - , Universität Duisburg-Essen (Autor:in)
  • Jennifer Landsberg - , Universität Bonn (Autor:in)
  • Inga Möller - , Universität Duisburg-Essen (Autor:in)
  • Antje Sucker - , Universität Duisburg-Essen (Autor:in)
  • Annette Paschen - , Universität Duisburg-Essen (Autor:in)
  • Eva Hadaschik - , Universität Duisburg-Essen (Autor:in)
  • Lisa Zimmer - , Universität Duisburg-Essen (Autor:in)
  • Elisabeth Livingstone - , Universität Duisburg-Essen (Autor:in)
  • Dirk Schadendorf - , Universität Duisburg-Essen (Autor:in)
  • Selma Ugurel - , Universität Duisburg-Essen (Autor:in)
  • Andreas Stang - , Universität Duisburg-Essen (Autor:in)
  • Klaus G. Griewank - , Universität Duisburg-Essen (Autor:in)

Abstract

Background: Melanomas lacking mutations in BRAF, NRAS and NF1 are frequently referred to as “triple wild-type” (tWT) melanomas. They constitute 5–10 % of all melanomas and remain poorly characterized regarding clinical characteristics and response to therapy. This study investigates the largest multicenter collection of tWT-melanomas to date. Methods: Targeted next-generation sequencing of the TERT promoter and 29 melanoma-associated genes were performed on 3109 melanoma tissue samples of the prospective multicenter study ADOREG/TRIM of the DeCOG revealing 292 patients suffering from tWT-melanomas. Clinical characteristics and mutational patterns were analyzed. As subgroup analysis, we analyzed 141 tWT-melanoma patients receiving either anti-CTLA4 plus anti-PD1 or anti PD1 monotherapy as first line therapy in AJCC stage IV. Results: 184 patients with cutaneous melanomas, 56 patients with mucosal melanomas, 34 patients with acral melanomas and 18 patients with melanomas of unknown origin (MUP) were included. A TERT promoter mutation could be identified in 33.2 % of all melanomas and 70.5 % of all tWT-melanomas harbored less than three mutations per sample. For the 141 patients with stage IV disease, mPFS independent of melanoma type was 6.2 months (95 % CI: 4–9) and mOS was 24.8 months (95 % CI: 14.2–53.4) after first line anti-CTLA4 plus anti-PD1 therapy. After first-line anti-PD1 monotherapy, mPFS was 4 months (95 %CI: 2.9–8.5) and mOS was 29.18 months (95 % CI: 17.5–46.2). Conclusions: While known prognostic factors such as TERT promoter mutations and TMB were equally distributed among patients who received either anti-CTLA4 plus anti-PD1 combination therapy or anti-PD1 monotherapy as first line therapy, we did not find a prolonged mPFS or mOS in either of those. For both therapy concepts, mPFS and mOS were considerably shorter than reported for melanomas with known oncogene mutations.

Details

OriginalspracheEnglisch
Aufsatznummer114208
FachzeitschriftEuropean journal of cancer
Jahrgang208
PublikationsstatusVeröffentlicht - Sept. 2024
Peer-Review-StatusJa

Externe IDs

PubMed 39018633
ORCID /0000-0003-4340-9706/work/169643427

Schlagworte

ASJC Scopus Sachgebiete

Schlagwörter

  • Immune therapy, Melanoma, Mutation profiling, Triple wild type