Combined stereotactic radiation therapy and immunotherapy for metastatic uveal melanoma

立体定向放射治疗联合免疫疗法治疗转移性葡萄膜黑色素瘤

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Abstract

AIM: Uveal melanoma (UM) is a rare primary intraocular malignant tumor with an extremely poor prognosis. Our study evaluated the feasibility to improve metastatic UM treatment outcomes with a combined approach of immunotherapy and radiation therapy. METHODS: The retrospective study enrolled 24 patients with metastatic uveal melanoma who had combined treatment with stereotactic radiation therapy (RT) and immune checkpoint inhibitor therapy. 35% of patients received combination immunotherapy, and the others received mono-immunotherapy with anti-PD-1 drugs. All patients underwent stereotactic RT for metastases in the liver (75% patients), bones (8%), soft tissues (8%), brain (4%), and lungs (4%). RESULTS: Overall response rate (ORR) was 39.1%. Complete response (CR) was achieved in 8.7% patients and partial response (PR) - in 30.4% patients, median progression free survival (PFS) was 11.6 months [95% confidence interval (CI), 5.4-14.4], and median overall survival (OS) was 27.6 months [95% CI, 16.9 - 49.1]. CONCLUSIONS: The study has demonstrated a safe combination of stereotactic radiation therapy and immune checkpoint inhibitor immunotherapy in patients with metastatic uveal melanoma. The combination shows a potential treatment option for this patient cohort since no other effective therapies are available at present.

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