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Younger patients with high-risk melanoma benefit from adjuvant Sutent
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CHICAGO — Sunitinib in the adjuvant setting is associated with greater overall survival in high-risk patients with uveal melanoma, especially younger patients, according to a speaker here.
“We’re starting to figure out metastatic risk for melanoma,” Carol L. Shields, MD, said at Ocular Oncology and Pathology Subspecialty Day preceding the American Academy of Ophthalmology annual meeting. “Gene expression profile neatly separates melanoma into two groups: class 1 with 3% risk for metastatic disease at 4 years and class 2 with an 80% risk.”
Shields said that she and her colleagues obtain genetic material by fine needle aspiration biopsy using a simple technique directly into the tumor.
Sutent (sunitinib, Pfizer), valproic acid and some new immunotherapies are among treatment options for high-risk melanoma, Shields said.
“Let’s focus on Sutent. It’s been around a while. It’s an oral medication, multitargeted tyrosine kinase inhibitor. It has antitumor, antiangiogenic and immune-modulating effects,” she said. Among other oncologic uses, it is used to prevent renal cell carcinoma in high-risk patients.
Shields and colleagues at Wills Eye Hospital trialed sunitinib for high-risk uveal melanoma patients with no metastasis. Low-dose Sutent taken for 6 months resulted in significantly improved survival compared with a control arm. Furthermore, survival rate at 6 years was 85% in patients younger than 60 years who were on adjuvant sunitinib, whereas survival rate in those with no adjuvant therapy was 40%.
“This was not the same for those patients over age 60. We found no benefit of Sutent in older patients,” she said. – by Patricia Nale, ELS
Reference:
Shields CL. Adjuvant therapy of high-risk uveal melanoma with sunitinib. Presented at: AAO Subspecialty Day; Oct. 26-27, 2018; Chicago.
Disclosure: Shields reports no relevant financial disclosures.