Notes on ESMO17: Melanoma

Clinical Brief – September 22nd

ESMO, or the European Society of Medical Oncology Congress, is an annual gathering of cancer experts and patient advocates. Here are some studies from this year’s ESMO that may be of use.

Active surveillance after surgery for uveal melanoma can help detect resectable liver metastases.

Researchers from the St Vincent’s University Hospital, Ireland, tested their active surveillance program where patients who’ve had surgery for uveal melanoma were monitored with periodic liver scans and clinical review.

Of the 160 odd patients who had registered between 2009 and 2017, 22% had metastatic relapses.

Of the patients with metastatic relapses, 80% showed no symptoms but were picked up on imaging. Nine patients underwent surgery to remove liver metastases, but 75% of patients had unresectable liver metastases.

Median overall survival for the cohort was 16 months.

Abstract #1240P

A slightly different way to look at blood work results may help predict treatment outcomes for patients on targeted- or immuno-therapy for metastatic melanoma.

Neutrophil and lymphocytes are types of white blood cells. Neutrophil and lymphocyte counts are routinely measured as part of the blood differential test.

Researchers from Australia looked at the ratio between neutrophil and lymphocyte counts in 174 patients being treated for metastatic melanoma; 74 were getting targeted therapies, 100 were getting immunotherapy.

They found that patients with neutrophil-to-lymphocyte ratios below 5 had significantly longer survival vs those whose ratios were above 5 (12 vs 5 months).

A larger cohort is needed to validate these results.

Abstract #1242P

Researchers from Italy followed about 160 patients with BRAFv600+ metastatic melanoma to learn about their responses to combination targeted therapy.

Most patients received dabrafenib (Tafinlar) + trametinib (Mekinist), and a few received vemurafenib (Zelboraf) + cobimetinib (Cotellic). Nearly 8 in 10 patients were treated in first-line.

Median overall survival was 18.3 months. Normal baseline LDH was linked to significantly longer survival than high baseline LDH (25 vs 10 months).

About 3 in 5 patients experienced cancer progression. The median time to progression or end of life was 10 months.

The median survival after progression was 2.5 months.

Abstract #1247P

For more presentations from #ESMO17, take a look at my hand-curated Twitter moment 🤓.


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