External Validation of a Dutch Predictive Nomogram for Complete Response to T-VEC in an Independent American Patient Cohort.
Ann Surg Oncol
; 29(3): 1637-1644, 2022 Mar.
Article
en En
| MEDLINE
| ID: mdl-34816368
ABSTRACT
PURPOSE:
Talimogene Laherparepvec (T-VEC) is a modified herpes simplex virus type-1 used as intralesional immunotherapy in stage IIIB-IVM1a melanoma patients. Recently, Stahlie et al. published a predictive model for complete response (CR) to T-VEC. This study was designed to validate this model externally in an independent, American patient cohort.METHODS:
In total, 71 stage IIIB-IVM1a melanoma patients treated with T-VEC at Moffitt Cancer Center were included. A second nomogram was built incorporating the same predictive factors tumor size (diameter of largest metastasis), type of metastases (cutaneous, subcutaneous and nodal), and number of metastases (cutoff < 20 and > 20). Predictive accuracy was assessed through calculation of overall performance, discriminative ability, and calibration.RESULTS:
The two cohorts were similar in many clinicopathologic factors and only differing in tumor mutational status and use of systemic therapy prior to T-VEC. In the validation cohort, 37 (52%) patients showed CR, 22 (31%) partial response (PR), 2 (5.6%) stable disease (SD), and 10 (15%) progressive disease (PD). Of those who demonstrated a CR, 16 (43%) recurred. Overall performance was good (0.164), and discriminative power resulted in fair discriminative ability (0.827). The calibration curve showed slight underestimation for predicted probabilities > 0.15 and slight overestimation <0.15.CONCLUSIONS:
The original model as well as the validation model show comparable and good predictive accuracy. The validation model reinforces the conclusion that for the best response to T-VEC, it should be used early on in the course of the disease, when the tumor burden is cutaneous with smaller diameter and fewer of metastases.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Cutáneas
/
Herpesvirus Humano 1
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Viroterapia Oncolítica
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Melanoma
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
País como asunto:
America do norte
Idioma:
En
Año:
2022
Tipo del documento:
Article