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Metastasis‐specific patterns of response and progression with anti‐PD‐1 treatment in metastatic melanoma |
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| Authors: | Jenny H J Lee Megan Lyle Alexander M Menzies Matthew M K Chan Serigne Lo Arthur Clements Matteo S Carlino Richard F Kefford Georgina V Long |
| Institution: | 1. Departments of Biomedical Sciences and Clinical Medicine, Macquarie University, Sydney, NSW, Australia;2. Melanoma Institute Australia, Sydney, NSW, Australia;3. Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia;4. University of Sydney, Sydney, NSW, Australia;5. Liz Plummer Cancer Care Centre, Cairns Hospital, Cairns, QLD, Australia;6. Royal North Shore Hospital, Sydney, NSW, Australia;7. Gosford Hospital, Gosford, NSW, Australia;8. Norwest hospital, Sydney, NSW, Australia;9. Sydney Adventist Hospital, Sydney, NSW, Australia |
| Abstract: | This study evaluated patterns of response as discerned by comprehensive metastasis‐specific analysis in metastatic melanoma patients receiving anti‐PD‐1 antibodies. Bi‐dimensional measurements of every metastasis in patients enrolled in the KEYNOTE‐001 trial at a single institution were obtained at baseline and throughout treatment. Twenty‐seven evaluable patients had 399 baseline metastases measurable on CT imaging. Complete response (CR) which occurred in 52.6% of metastases was smaller (mean 223 mm2 versus 760 mm2, p < .01) and occurred more frequently in the lungs (65% versus 39.4%, p < .01). Response was heterogenous (new/progressing metastases alongside CR metastases) at first assessment in 4/14 patients with objective response (OR) as opposed to 7/13 patients with non‐OR. CR of individual metastases is common and influenced by site and size. Most patients with OR demonstrate homogenous regression in all metastases at the first assessment. In contrast, patients with early heterogeneity had a poor outcome. |
| Keywords: | immune‐related response criteria immunotherapy melanoma pembrolizumab programmed‐death receptor 1 |