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Archive > Volume 30 Issue 7 > 2023,30(7):612-615. DOI:10.3872/j.issn.1007-385X.2023.07.009 Prev Next
Clinical Research
Immunotherapy efficacy in 79 patients with malignant esophageal melanoma and the prognostic factors
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Abstract:
Objective: To explore clinical characteristics of patients with malignant esophageal melanoma (MEM) and analyze the efficacy and prognostic factors of PD-1 monoclonal antibody-based immunotherapy. Methods: Clinical data of patients with unresectable or metastatic MEM in the Department of Melanoma and Sarcoma of Peking University Cancer Hospital from May 2011 to June 2022 were collected, including basic information, pathological data, laboratory indicators, treatment patterns and survival situation. The clinical efficacy was evaluated using the Response Evaluation Criteria in Solid Tumors 1.1 (RECST 1.1). Kaplan-Meier curve was used for survival analysis, and univariate and multivariate COX regression analyses were used to screen prognostic factors. Results: A total of 79 MEM patients with complete data were enrolled, with a median age of 59.0. Most of the patients were accompanied by choking and dysphagia with the most common anatomic site of lower esophagus. There was a high mutant rate in NRAS and KIT, and the rate of LDH elevation accounted for 21.5%. Among them, 17 patients received chemotherapy, and 62 patients received PD-1 monoclonal antibody-based immunotherapy. The objective response rate (ORR) was 5.9% and 28.8%, and disease control rate ( DCR) was 35.3% and 72.9%, respectively. Overall survival (OS) in immune therapy group was significantly longer (13.2 months, 95%CI [9.5,16.9] months vs 7.0 months, 95%CI [0,16.7] months, P=0.019) than that in the chemotherapy group. Multivariate analysis showed that OS was significantly correlated with serum LDH, ECOG score, clinical symptoms and PD-1 monoclonal antibody-based immunotherapy (all P<0.05). Conclusion: MEM patients respond better to immune therapy, and elevated serum LDH, ECOG≥2, clinical symptoms at visiting might be the poor prognosis factors.
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