Table 2.
Response rates from previous studies using different modalities of treatment for advanced melanoma
| Reference | Study therapy type | Patient no | Duration of follow-up (years) | Complete response | Overall response (CR + PR) | Any response (CR + PR + SD) | Median overall survival |
|---|---|---|---|---|---|---|---|
| Chemotherapy | |||||||
| Hill et al1 | DTIC | 143 | 5.7 | 5% | 20% | 62% | 33 m |
| Robert et al24 | DTIC | 252 | 4.5 | 0.8% | 10.3% | 30.2% | 9.1 m |
| Chapman et al25 | DTIC | 220 | 0.5 | 0% | 5.4% | ns | ns |
| Middleton et al26 | DTIC | 149 | 1.6 | 2.7% | 12.1% | 27.9% | 6.4 m |
| Flaherty et al27 | DTIC | 108 | 2.1 | 0% | 8% | 39% | ns |
| Middleton et al26 | Temozolomide | 156 | 1.6 | 2.6% | 13.5% | 31.4% | 7.7 m |
| Bedikian et al28 | Docetaxel | 40 | 3 | 2.5% | 12.5% | 67.5% | 13 m |
| Avril et al29 | Dacarbazine | 117 | 0.9% | 6.9% | 21.4% | 5.6 m | |
| Avril et al29 | Fotemustine | 112 | 2.7% | 15.2% | 32.2% | 7.3 m | |
| B-raf inhibitors | |||||||
| Flaherty et al30 | B-raf inhib | 49 32 |
0.8 | 1%† (2%) 3.1%† (6.25%) |
11.2%† (22.5%) 40.63%† (81.25%) |
ns | ns |
| Chapman et al25 | B-raf inhib vemurafenib | 219 | 0.5 | 0.45%† (0.9%) | 24.2%† (48.4%) | ns | ns |
| Flaherty et al31 | B-raf inhib dabrafenib | 54 | 1 | 2%† (4%) | 27%† (54%) | 47.5%† (95%) | ns |
| Immunotherapies | |||||||
| Atkins et al32 | IL-2 | 270 | >7 | 6% | 16% | ns | 12 m |
| Prieto et al20 | IL-2 + CTLA-4 | 36 | 7 | 17% | 25% | ns | ns |
| Hodi et al33 | CTLA-4 | 137 | 4.6 | 1.5% | 11% | 28.5% | 10.1 m |
| Robert et al24 | DTIC + CTLA-4 | 250 | 4.5 | 1.6% | 15.2% | 33.2% | 11.2 m |
| Coventry et al23 | VMCL vaccine | 37 | 6 | 18.9% | 37.8% | 83.7% | 10 m |
| Coventry et al17 | VMCL vaccine | 54 | 10.1 | 16.7% | 31.5% | 77.8% | 14 m |
| Rosenberg et al34 | TIL + IL-2 | 93 | 6.8 | 22% | 56% | ns | ns |
| MEK inhibitors | |||||||
| Flaherty et al27 | MEK inhib alone | 214 | 2.1 | 1%† (2%) | 11%† (22%) | 39%† (78%) | ns |
| Flaherty et al31 | B-raf + MEK inhib overall† | 162 | 1 | 3.1%† (6.2%) | 29.9%† (59.9%) | 48.2% †(96.3%) | ns |
| Flaherty et al31 | B-raf + MEK/1 corrected value† | 54 | 1 | 3%† (6%) | 25%† (50%) | 47%† (94%) | ns |
| Flaherty et al31 | B-raf + MEK/2 corrected value† | 54 | 1 | 4.5%† (9%) | 38%† (76%) | 50%† (100%) | ns |
| PD-1 inhibitors | |||||||
| Topalian et al35 | PD-1 (nivolumab) | 94 | 3 | 1% | 28% | 34% | ns |
| Topalian et al36 | 107 | 0.9% | 31% | 38% | 16.8 m | ||
| Hamid et al37 | PD-1 (lambrolizumab) | 117 | 1.33 | 5.1% | 38% | ns | ns |
| Wolchok et al38 | PD-1 + CTla-4 | 82 | 2.5 | 7.3% | 32.9% | ns | ns |
| Concurrent therapy | 52 | 9.6% | 40.4% | 48% | ns | ||
| Sequential therapy | 30 | 3.3% | 20% | ns | ns | ||
| PDL-1 | |||||||
| Brahmer et al39 | PDL-1 | 55 | 2.9 | 5.8% | 17.3% | 44.2% | ns |
Notes:
Approximately 50% of patients show the B-raf V600E mutation in their melanomas, the results for B-raf inhibitory therapy are therefore selected for these patients and represent statistically selected figures. For statistical comparison with unselected patients, these results require correction by dividing the figures by 2 to enable accurate and valid comparisons with other treatments which report results for 100% of melanoma patients. # deaths were in 3 of 296 patients in a trial of mixed tumor types (lung and colon, rather than melanoma). Every effort has been made to accurately represent the reported data, however, there was some inter-study variability in reporting methods between studies, and data was not uniformly reported using standard methods or was missing/unobtainable from some studies thereby inhibiting comparisons between studies. The manner in which the data was presented varied between different study reports.1,23–39 Adapted and reproduced with permission from Australian Melanoma Research Foundation data 2014 http://www.melanomaresearch.com.au.
Abbreviations: CR, complete response; PR, partial response; SD, stable disease; DTIC, dacarbazine; ns, not specified; B-raf, B-raf mutant pathway inhibitors vemurafenib and dabrafenib; inhib, inhibitor; IL2, interleukin-2; CTLA-4, anti-cytotoxic lymphocyte antigen-4 inhibitory antibodies ipilimumab and Yervoy; VMCL, vaccinia melanoma cell lysate vaccine; TIL, autologous tumor infiltrating lymphocytes; MEK, mitogen-activated protein kinase inhibitors; MEK/1, 1 mg dose; MeK/2, 2 mg dose; PD-1, programmed death receptor inhibitors; PDl-1, programmed death-1 receptor ligand inhibitory monoclonal antibody; m, months.