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Soo Park, MD
Soo Park, MD
Posted: Monday, December 9, 2024
A combination of minimally invasive cryoablation and postprogression immune checkpoint inhibition may be a useful therapeutic approach for patients with metastatic melanoma, according to Meghan J. Mooradian, MD, of Harvard Medical School, Boston, and colleagues. In fact, 41% of patients with unresectable melanoma whose disease progressed with immune checkpoint inhibition experienced disease control after cryoablation, and tumor regression in nonablated sites was present for all responders. The findings of this nonrandomized, phase II, single-center study were published in Nature Communications.
“All enrolled patients, even those with an Eastern Cooperative Oncology Group performance status of 2, safely underwent cryoablation,” stated the study investigators. “Though limited by crosstrial comparisons, the objective response rate of 23.5% and progression-free and overall survival rates at 1 year are comparable to [or better than] the existing data in the post-anti–PD-1 setting of combination anti–PD-1 plus tyrosine kinase inhibitors, Toll-like receptor agonists, and epigenetic modifiers.”
Patients treated at Massachusetts General Hospital with unresectable or metastatic cutaneous melanoma who had progressive disease in at least two sites were enrolled (n = 18). Patients underwent image-guided percutaneous cryoablation followed by two additional cycles of the same PD-1 inhibitor they had received prior to disease progression. The procedure appeared to be relatively safe, with most adverse events appearing mild and manageable, and without an increased rate of immune-related adverse events following cryoablation.
Four partial responses and three cases of stable disease were observed, with durable disease control lasting at least 6 months for these responding patients. In responders, tumor regression was found to be higher than previously reported responses to postprogression immune checkpoint inhibition alone (P = .076). The median duration of response was 771.5 days for patients who responded to treatment and 356 days for patients who experienced disease control. The 6-month progression-free survival rate was 23.5%, and the 1-year overall survival rate was 53%.
Disclosure: For full disclosures of the study authors, visit nature.com.
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