Limited Efficacy of Immune Checkpoint Inhibitors in Metastatic Uveal Melanoma

Immune checkpoint inhibitors have shown limited efficacy in the treatment of metastatic uveal melanoma, according to the results of a recent systematic review and meta-analysis.

“Immune checkpoint inhibitors have been trialed in metastatic uveal melanoma; however, robust conclusions regarding their efficacy are difficult to draw given small study sizes and heterogenous patient populations,” the authors noted.

The researchers searched five databases for studies on immune checkpoint inhibitors in metastatic uveal melanoma. Data on patient demographics, objective response rate (ORR), overall survival, and progression-free survival were included.

The results indicated that the pooled ORR was 9.2% overall (95% CI, 7.2-11.8). Further, the pooled ORR was 4.1% for anti-CTLA4 (95% CI, 2.1-7.7). For anti-PD(L)1 the pooled ORR was 7.1% (95% CI, 4.5-10.9) and 13.5% for anti-CTLA4 plus anti-PD1 (95% CI, 10.0-18.0).

The median overall survival was 11.5 months (95% CI, 9.5-13.8). The medial overall survival was 8.0 months (95% CI, 5.5-9.9), 11.7 months (95% CI, 9.0-14.0), and 16.0 months (95% CI, 11.5-17.7) for anti-CTLA4, anti-PD(L)1, and ipilimumab plus anti-PD1, respectively. The overall median progression-free survival was 3.0 months (95% CI, 2.9-3.1).

However, the researchers noted that further biomarker profiling studies may be beneficial to guide treatment in these patients.

“Immune checkpoint inhibitors have limited efficacy in metastatic uveal melanoma and a recommendation for their use must consider the balance of benefit and risk for individual patients if no other options are available,” the authors concluded.

Reference:
Pham JP, On L, Ardolino L, et al. Efficacy of immune checkpoint inhibition in metastatic uveal melanoma: a systematic review and meta-analysis. Melanoma Res. 2023;33(4):316-325. doi:10.1097/CMR.0000000000000900.