Background: The introduction of immuno- and targeted therapeutic modalities meant a breakthrough step in the therapy of melanoma. As a checkpoint inhibitor, the more effective and less toxic anti-PD1 therapy followed an anti-CTLA4 approach. Methods: From our patient pool, 222 advanced melanoma cases were selected, where anti-PD1 (pembrolizumab, nivolumab) therapy was initiated between March 2015 and December 2020. During our retrospective analysis, the efficacy and safety of the therapy were assessed. Results: The median follow-up was 16 months (interval: 0–64 months), and 150 patients (67.6%) received therapy in the first line, while second and third line therapy was performed among 72 patients (32.4%) for the median of 7.0 months (0–60). In 50 cases, BRAF mutations were detected. Ninety-six patients showed objective response (11.3% CR, 32.0% PR). The median PFS was 10.0 months (0–60), and the median OS was 23.0 months (0–64). Autoimmune side effects were found in 79 patients (35.5%); grade 3 occurred in 6.3% of the cases, while 1 patient died due to fulminant pneumonitis (0.25%). Conclusion: Although the range of immunotherapeutic options is getting wider, in the management of melanoma patients, anti-PD1 monotherapy remains an important, effective, and safe method. However, significant correlation was found between the immune-related side effects and therapeutic efficacy.
背景：免疫和靶向治疗方式的引入意味着黑色素瘤治疗的一个突破性步骤。作为检查点抑制剂，更有效且毒性更低的抗PD1疗法继抗CTLA4方法之后。方法：从我们的患者池中，选取了222例晚期黑色素瘤病例，这些病例在2015年3月至2020年12月期间开始了抗PD1（帕博利珠单抗、纳武利尤单抗）治疗。在我们的回顾性分析中，评估了该治疗的疗效和安全性。结果：中位随访时间为16个月（范围：0-64个月），150名患者（67.6%）接受了一线治疗，而72名患者（32.4%）接受了二线和三线治疗，中位治疗时间为7.0个月（0-60）。在50例病例中检测到BRAF突变。96名患者显示出客观缓解（11.3%完全缓解，32.0%部分缓解）。中位无进展生存期为10.0个月（0-60），中位总生存期为23.0个月（0-64）。79名患者（35.5%）出现自身免疫副作用；3级副作用发生在6.3%的病例中，而1名患者因暴发性肺炎死亡（0.25%）。结论：尽管免疫治疗的选择范围越来越广，但在黑色素瘤患者的管理中，抗PD1单药治疗仍然是一种重要、有效且安全的方法。然而，免疫相关副作用与治疗效果之间存在显著相关性。
肿瘤(癌症)患者之家