Lactate dehydrogenase as a selection criterion for ipilimumab treatment in metastatic melanoma
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  • 作者:Sander Kelderman (1)
    Bianca Heemskerk (1)
    Harm van Tinteren (1)
    Rob R. H. van den Brom (2)
    Geke A. P. Hospers (2)
    Alfonsus J. M. van den Eertwegh (3)
    Ellen W. Kapiteijn (4)
    Jan Willem B. de Groot (5)
    Patricia Soetekouw (6)
    Rob L. Jansen (6)
    Edward Fiets (7)
    Andrew J. S. Furness (8)
    Alexandra Renn (8)
    Marcin Krzystanek (9)
    Zoltan Szallasi (9)
    Paul Lorigan (10)
    Martin E. Gore (8)
    Ton N. M. Schumacher (1)
    John B. A. G. Haanen (1)
    James M. G. Larkin (8)
    Christian U. Blank (1)
  • 关键词:Melanoma ; Immunotherapy ; Ipilimumab ; Lactate dehydrogenase ; Biomarker
  • 刊名:Cancer Immunology, Immunotherapy
  • 出版年:2014
  • 出版时间:May 2014
  • 年:2014
  • 卷:63
  • 期:5
  • 页码:449-458
  • 全文大小:336 KB
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  • 作者单位:Sander Kelderman (1)
    Bianca Heemskerk (1)
    Harm van Tinteren (1)
    Rob R. H. van den Brom (2)
    Geke A. P. Hospers (2)
    Alfonsus J. M. van den Eertwegh (3)
    Ellen W. Kapiteijn (4)
    Jan Willem B. de Groot (5)
    Patricia Soetekouw (6)
    Rob L. Jansen (6)
    Edward Fiets (7)
    Andrew J. S. Furness (8)
    Alexandra Renn (8)
    Marcin Krzystanek (9)
    Zoltan Szallasi (9)
    Paul Lorigan (10)
    Martin E. Gore (8)
    Ton N. M. Schumacher (1)
    John B. A. G. Haanen (1)
    James M. G. Larkin (8)
    Christian U. Blank (1)

    1. Netherlands Cancer Institute NKI-AVL, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
    2. University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
    3. VU University Medical Center, De Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands
    4. Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
    5. Isala Clinics, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands
    6. Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
    7. Medical Center Leeuwarden, Henri Dunantweg 2, 8934 AD, Leeuwarden, The Netherlands
    8. Royal Marsden Hospital, 197 Fulham Road, London, SW3 6JJ, UK
    9. Technical University of Denmark, Anker Engelunds Vej 1, 2800, Kongens Lyngby, Denmark
    10. Christie Hospital, 550 Wilmslow Road, Manchester, M20 4BX, UK
  • ISSN:1432-0851
文摘
Introduction Ipilimumab, a cytotoxic T lymphocyte-associated antigen-4 blocking antibody, has improved overall survival (OS) in metastatic melanoma in phase III trials. However, about 80?% of patients fail to respond, and no predictive markers for benefit from therapy have been identified. We analysed a ‘real world-population of patients treated with ipilimumab to identify markers for treatment benefit. Methods Patients with advanced cutaneous melanoma were treated in the Netherlands (NL) and the United Kingdom (UK) with ipilimumab at 3?mg/kg. Baseline characteristics and peripheral blood parameters were assessed, and patients were monitored for the occurrence of adverse events and outcomes. Results A total of 166 patients were treated in the Netherlands. Best overall response and disease control rates were 17 and 35?%, respectively. Median follow-up was 17.9?months, with a median progression-free survival of 2.9?months. Median OS was 7.5?months, and OS at 1?year was 37.8?% and at 2?years was 22.9?%. In a multivariate model, baseline serum lactate dehydrogenase (LDH) was demonstrated to be the strongest predictive factor for OS. These findings were validated in an independent cohort of 64 patients from the UK. Conclusion In both the NL and UK cohorts, long-term benefit of ipilimumab treatment was unlikely for patients with baseline serum LDH greater than twice the upper limit of normal. In the absence of prospective data, clinicians treating melanoma may wish to consider the data presented here to guide patient selection for ipilimumab therapy.

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