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2019 ASCO Annual Meeting!

Session: Melanoma/Skin Cancers

Type: Oral Abstract Session

Time: Tuesday June 4, 9:45 AM to 12:45 PM

Location: S406

Salvage therapy after failure from anti-PD-1 single agent treatment: A Study by the German ADOReg melanoma registry.

Advanced Disease

Melanoma/Skin Cancers

2019 ASCO Annual Meeting

Abstract No:

J Clin Oncol 37, 2019 (suppl; abstr 9505)

Author(s): Michael Weichenthal, Selma Ugurel, Ulrike M. Leiter, Imke Satzger, Katharina C. Kähler, Julia Welzel, Claudia Pföhler, Ingrid Feldmann-Böddeker, Friedegund Elke Meier, Patrick Terheyden, Sebastian Haferkamp, Rudolf Herbst, Jens Ulrich, Jochen Utikal, Alexander Kreuter, Ralf Gutzmer, Dirk Schadendorf, Peter Mohr; University Department of Dermatology, Kiel, Germany; Department of Dermatology, University Hospital Erlangen and Department of Dermatology, University of Würzburg, Essen, Germany; Department of Dermatooncology, University of Tübingen, Tuebingen, Germany; Hannover Medical School, Hannover, Germany; Universitats-Hautklinik Kiel, Kiel, Germany; Klinikum Augsburg, Augsburg, Germany; Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany; DRK Hospital Chemnitz-Rabenstein, Chemnitz, Germany; Department of Dermatology, University Hospital Dresden, Dresden, Germany; Department of Dermatology University of Lübeck, Lübeck, Germany; Department of Dermatology, University Hospital Regensburg, Regensburg, Germany; HELIOS Hauttumorzentrum Erfurt, Erfurt, Germany; Medical Center Quedlinburg, Quedlinburg, Germany; Skin Cancer Unit, German Cancer Research Center (DKFZ), and Department of Dermatology, Venerology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany; HELIOS St. Elisabeth Hospital Oberhausen, University Witten/Herdecke, Oberhausen, Germany; Skin Cancer Center Hannover, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany; Universitaetsklinikum Essen & German Cancer Consortium, Essen, Germany; Elbe Kliniken Buxtehude, Buxtehude, Germany

Abstract Disclosures


Background: In melanoma, potential benefits of therapies after PD-1 inhibitor failure, including those BRAF positive patients who have already received combined BRAF-/MEK inhibitors before anti PD-1 are poorly defined. We therefore analyzed the treatment patterns and outcome of systemic therapies for patients after anti-PD-1 failure. Methods: From the ADOReg registry, patients fulfilling the following inclusion criteria were consecutively included until a number of 200 cases was reached. 1) Ipilimumab naive patients with unresectable metastatic cutaneous or mucosal melanoma. 2) Failure from treatment with a single agent anti PD-1 antibody. 3) Known BRAF status and, in case of BRAF-V600 mutation, BRAF-/MEK-inhibitor treatment prior to anti PD-1 treatment. 4) Consecutive systemic treatment started within a maximum of 6 months after anti PD-1 failure. Objectives: Rate of objective remissions (ORR), disease control (DCR), survival (OS), tolerability and disease patterns correlated to the use of different treatments after PD-1 treatment failure in real-life conditions in Germany. Results: In total 23.5 % of the patients received ipilimumab single agent, 38.5 % received the combination of ipilimumab and nivolumab (Ipi/Nivo), and the remaining various regimens. (Table) Ipi/Nivo resulted in an ORR significantly higher than for Ipi alone (p=0.02). In 18 patients receiving BRAF-/MEK inhibitor re-challenge, ORR was comparable to Ipi/Nivo. Conventional Chemotherapy was still in frequent use (dacarbazine n =33; other n=17), but response rates were low (ORR 6%). Some remission were also achieved by use of talimogene laherparepvec (n=2 out of 4). Conclusions: Treatment patterns of patients after anti-PD-1 failure differ remarkably. Although lower than reported in treatment naive patients, the combination of Ipilimumab and Nivolumab appeared favorable as compared to all other regimens, except for BRAF-/MEK inhibitor re-challenge which produced similar remission rates. Still, chemotherapies including dacarbazine are in clinical practice, though giving only poor outcome.

IpilimumabIpilimumab/NivolumabBRAF-/MEK-i Re-treatmentOther*Total
Patients n47771858200
Median age [years]
Objective remissions2 (4.2%)15 (19.5%)4 (22.2%)7 (12.1%)28 (14.0%)
Disease control rate9 (17.0%)34 (44.2%)7 (38.9%)14 (24.2%)64 (32.0%)

Other Abstracts in this Sub-Category:


1. Phase 3 international trial of adjuvant whole brain radiotherapy (WBRT) or observation (Obs) following local treatment of 1-3 melanoma brain metastases (MBMs).

Meeting: 2019 ASCO Annual Meeting Abstract No: 9500 First Author: Gerald Fogarty
Category: Melanoma/Skin Cancers - Advanced Disease


2. Efficacy and safety of the combination of nivolumab (NIVO) plus ipilimumab (IPI) in patients with symptomatic melanoma brain metastases (CheckMate 204).

Meeting: 2019 ASCO Annual Meeting Abstract No: 9501 First Author: Hussein Abdul-Hassan Tawbi
Category: Melanoma/Skin Cancers - Advanced Disease


3. Correlates of overall survival (OS) in metastatic uveal melanoma (mUM) and a randomized trial of cabozantinib (cabo) versus chemotherapy (chemo).

Meeting: 2019 ASCO Annual Meeting Abstract No: 9506 First Author: Daniel Olson
Category: Melanoma/Skin Cancers - Advanced Disease