Evidence map›Paper›PMID 35874737›Full record

ArticleFrontiers in immunology2022

Early Response Assessment in Advanced Stage Melanoma Treated with Combination Ipilimumab/Nivolumab.

Vincent T Ma, Alahendra A Chamila Perera, Yilun Sun, Merna Sitto, Jessica J Waninger, Govind Warrier, Michael D Green, Leslie A Fecher, Christopher D Lao

Open access · goldAbstract read
In one paragraph

Article in Frontiers in immunology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Vincent T MaDepartment of Internal Medicine, Division of Hematology, Medical Oncology, and Palliative Care, University of Wisconsin, Madison, WI, United States.
Alahendra A Chamila PereraDepartment of Biostatistics, University of Michigan, Ann Arbor, MI, United States.
Yilun SunDepartment of Biostatistics, University of Michigan, Ann Arbor, MI, United States.
Merna SittoDepartment of Medical Education, University of Michigan, Ann Arbor, MI, United States.
Jessica J WaningerDepartment of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States.
Govind WarrierDepartment of Internal Medicine, University of Michigan, Ann Arbor, MI, United States.
Michael D GreenDepartment of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States.
Leslie A FecherDepartment of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, United States.
Christopher D LaoDepartment of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, United States.
Michigan United · USUniversity of Michigan–Ann Arbor · US

Funding

MICHIGAN MEDICAL SCIENTIST TRAINING PROGRAMT32GM007863 · NIGMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI COLLINS, KATHLEEN L. · 1985 to 2024
$38.3M
NIGMS NIH HHS T32 GM007863
6 · The paper itself

Abstract

Background: Standard combination ipilimumab/nivolumab (I/N) is given as 4 induction doses for advanced stage melanoma followed by nivolumab single-agent maintenance therapy. While many patients receive less than 4 doses due to immune-related toxicities, it is unclear if fewer doses of I/N may still provide long term clinical benefit. Our aim is to determine if response assessment after 1 or 2 doses of I/N can predict long-term survival and assess if fewer doses of I/N can lead to similar survival outcomes. Methods: We performed a retrospective analysis on a cohort of patients with advanced melanoma who w0ere treated with standard I/N. Cox regression of progression-free survival (PFS) and overall survival (OS) models were performed to assess the relationship between response after 1 or 2 doses of I/N and risk of progression and/or death. Clinical benefit response (CBR) was assessed, defined as SD (stable disease) + PR (partial response) + CR (complete response) by imaging. Among patients who achieved a CBR after 1 or 2 doses of I/N, a multivariable Cox regression of survival was used to compare 1 or 2 vs 3 or 4 doses of I/N adjusted by known prognostic variables in advanced melanoma. Results: 199 patients were evaluated. Patients with CBR after 1 dose of I/N had improved PFS (HR: 0.16, 95% CI 0.08-0.33; p<0.001) and OS (HR: 0.12, 0.05-0.32; p<0.001) compared to progressive disease (PD). Patients with CBR (vs PD) after 2 doses of I/N also had improved PFS (HR: 0.09, 0.05-0.16; p<0.001) and OS (HR: 0.07, 0.03-0.14; p<0.001). There was no survival risk difference comparing 1 or 2 vs 3 or 4 doses of I/N for PFS (HR: 0.95, 0.37-2.48; p=0.921) and OS (HR: 1.04, 0.22-4.78; p=0.965). Conclusions: Early interval imaging with response during induction with I/N may be predictive of long-term survival in advanced stage melanoma. CBR after 1 or 2 doses of I/N is associated with favorable survival outcomes, even in the setting of fewer I/N doses received. Further studies are warranted to evaluate if electively administering fewer combination I/N doses despite tolerance in select patients may balance the benefits of therapy while decreasing toxicities.

Indexed as

Antineoplastic Agents, ImmunologicalImmune Checkpoint InhibitorsIpilimumabMelanomaNivolumabAntineoplastic Combined Chemotherapy ProtocolsHumansRetrospective StudiesAntineoplastic Agents, ImmunologicalImmune Checkpoint InhibitorsIpilimumabNivolumabbiomarkercombination immune checkpoint therapyearly response assessmentimmune related adverse effectsipilimumab and nivolumabmelanomaradiological assessment

Identifiers

PMID35874737
PMCPMC9296775
OpenAlexW4283836963

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.