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Article dans une revue
Impact of radiotherapy administered simultaneously with systemic treatment in patients with melanoma brain metastases within MelBase, a French multicentric prospective cohort
Pauline Tétu
1
Clara Allayous
1
Bastien Oriano
2
Stéphane Dalle
3
Laurent Mortier
4
Marie-Thérèse Leccia
5
Bernard Guillot
6
Sophie Dalac
7
Caroline Dutriaux
8
Jean-Philippe Lacour
9
Philippe Saiag
10
Florence Brunet-Possenti
11
Julie de Quatrebarbes
12
Pierre-Emmanuel Stoebner
13
Delphine Legoupil
14
Marie Beylot-Barry
8
Thierry Lesimple
15
François Aubin
16
Brigitte Dreno
17
Sameh Mohamed
1
Alice Ballon
18
Raphaël Porcher
2
Céleste Lebbé
1
Laurent Mortier 4
Auteur IdHAL : laurent-mortier
Marie-Thérèse Leccia 5
Auteur
Bernard Guillot 6
Auteur
Sophie Dalac 7
Auteur
Caroline Dutriaux 8
Auteur
Jean-Philippe Lacour 9
Auteur
Philippe Saiag 10
Auteur
Florence Brunet-Possenti 11
Auteur
Julie de Quatrebarbes 12
Auteur
Pierre-Emmanuel Stoebner 13
Auteur
Delphine Legoupil 14
Auteur
Marie Beylot-Barry 8
Auteur
1
HIPI (UMR_S_976 / U976) - Immunologie humaine, physiopathologie & immunithérapie ("Hôpital Saint Louis - Pavillon Bazin
1 avenue Claude Vellefaux
75010 Paris"
- France)
- INSERM - Institut National de la Santé et de la Recherche Médicale : U976 (101, rue de Tolbiac, 75013 Paris - France)
- UP - Université de Paris : UMR_S_976 (85 boulevard Saint-Germain 75006 Paris - France)
2
Centre de Diagnostic et de Thérapeutique, Hôpital de l’Hôtel-Dieu [Paris] (Paris - France)
3
Laboratoire de Cytogénétique Constitutionnelle [Hospices civils de Lyon] (Bron 69500 - France)
- HCL - Hospices Civils de Lyon (3 Quai des Célestins 69002 Lyon - France)
4
CHRU Lille - Centre Hospitalier Régional Universitaire [Lille] (2, avenue Oscar Lambret - 59037 Lille Cedex - France)
5
CHU - Centre Hospitalier Universitaire [Grenoble] (CS 10217
38043 Grenoble cedex 9 - France)
6
CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier] (191 avenue du doyen Gaston Giraud 34295 Montpellier cedex 5 - France)
7
Service de Dermatologie (CHU de Dijon) (CHU de Dijon - 14 rue Paul Gaffarel - 21079 Dijon - France)
- CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon - 14 rue Paul Gaffarel - 21079 Dijon - France)
8
CHU Bordeaux [Bordeaux] (place Amélie Raba Léon
33076 BORDEAUX CEDEX - France)
9
Service de Dermatologie [Nice] (CS 23079
06202 Nice cedex 3 - France)
- CHU - Hôpital Archet 2 [Nice] (CS 23079 06202 Nice cedex 3 - France)
10
Hôpital Ambroise Paré [AP-HP] (9, avenue Charles de Gaulle92104 Boulogne-Billancourt cedex - France)
11
AP-HP - Hôpital Bichat - Claude Bernard [Paris] (46 Rue Henri Huchard, 75018 Paris - France)
12
Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois] (Chemin du Loup BP 14110
74164 Saint-Julien-en-Genevois Cedex
- France)
13
CHU Nîmes - Centre Hospitalier Universitaire de Nîmes (4 Rue du Professeur Robert Debré, 30029 Nîmes - France)
14
CHU - BREST - Hôpital Morvan - CHRU de Brest (2 Avenue Maréchal Foch, 29200 Brest - France)
15
CRLCC - Centre Eugène Marquis (Avenue Bataille Flandres-Dunkerque 35042 RENNES CEDEX - France)
17
CHU Nantes - Centre hospitalier universitaire de Nantes (1 Place Alexis-Ricordeau, 44000 Nantes - France)
18
SBIM - Service de biostatistique et information médicale de l’hôpital Saint Louis (Equipe ECSTRA) (SBIM - Hôpital Saint Louis,
1 avenue Claude Vellefaux
75010 Paris - France)
- INSERM - Institut National de la Santé et de la Recherche Médicale : UMR 1153 (101, rue de Tolbiac, 75013 Paris - France)
- INCA - Institut national du cancer [Boulogne] (Institut National du Cancer 52, avenue André Morizet 92513 Boulogne Billancourt Cedex - France)
- CHU Saint Louis [APHP] (Hôpital Saint Louis, 1 avenue Claude Vellefaux 75010 Paris - France)
- UP - Université de Paris (85 boulevard Saint-Germain 75006 Paris - France)
Abstract : Background: Melanoma brain metastases (MBMs) are historically associated with poor prognosis. Radiation therapy is conventionally associated with a high local control rate. Development of targeted therapy and immunotherapy has improved overall survival (OS) and intracranial response rate, but about 50% of patients failed to respond to these novel therapies. The objective of this study was to assess the impact of combined radiotherapy (cRT) on overall survival in a large multicenter real-life prospective cohort of patients with MBM treated with immunotherapy or targeted therapy.
Patients and methods: Clinical data from 262 patients with MBM were collected via MelBase, a French multicentric biobank prospectively enrolling unresectable stage III or IV melanoma. Two groups were defined: patients receiving cRT (cRT group) or not receiving cRT (no-cRT group). Primary end-point was OS. Propensity score weighting was used to correct for indication bias.
Results: Among the 262 patients, 93 (35%) received cRT (cRT group). The patients were treated with immunotherapy in 69% and 60% and with targeted therapy in 31% and 40% of the cRT and no-cRT groups, respectively. With a median follow-up of 6.9 months, median OS was 16.8 months and 6.9 months in the cRT and no-cRT groups, respectively. After propensity score weighting, cRT was associated with longer OS (hazard ratio = 0.6, 95% confidence interval: 0.4-0.8; p=0.007). Median OS after ponderation was 15.3 months and 6.2 months in the cRT and no-cRT groups, respectively.
Conclusion: This study shows that cRT may be associated with a significant decrease of 40% in the risk of death in patients with MBM treated with systemic therapy.
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Article dans une revue
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https://hal.umontpellier.fr/hal-02872129
Contributeur : Nathalie Salvy-Cordoba <>
Soumis le : mercredi 17 juin 2020 - 15:42:06
Dernière modification le : jeudi 15 avril 2021 - 15:08:16
Contributeur : Nathalie Salvy-Cordoba <>
Soumis le : mercredi 17 juin 2020 - 15:42:06
Dernière modification le : jeudi 15 avril 2021 - 15:08:16
Identifiants
- HAL Id : hal-02872129, version 1
- DOI : 10.1016/j.ejca.2019.02.009
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Citation
Pauline Tétu, Clara Allayous, Bastien Oriano, Stéphane Dalle, Laurent Mortier, et al.. Impact of radiotherapy administered simultaneously with systemic treatment in patients with melanoma brain metastases within MelBase, a French multicentric prospective cohort. European Journal of Cancer, Elsevier, 2019, 112, pp.38-46. ⟨10.1016/j.ejca.2019.02.009⟩. ⟨hal-02872129⟩
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