Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Tolerance and Effectiveness of Targeted Therapies in Aged Patients with Metastatic Melanoma

Version 1 : Received: 15 June 2021 / Approved: 17 June 2021 / Online: 17 June 2021 (13:59:08 CEST)

How to cite: Becquart, O.; Oriano, B.; Dalle, S.; Mortier, L.; Leccia, M.T.; Dutriaux, C.; Dalac, S.; Montaudié, H.; de Quatrebarbes, J.; Brunet-Possenti, F.; Saiag, P.; Lesimple, T.; Beylot-Barry, M.; Aubin, F.; Stoebner, P.E.; Arnault, J.P.; Dreno, B.; Porcher, R.; Lebbé, C.; Guillot, B. Tolerance and Effectiveness of Targeted Therapies in Aged Patients with Metastatic Melanoma. Preprints 2021, 2021060460 (doi: 10.20944/preprints202106.0460.v1). Becquart, O.; Oriano, B.; Dalle, S.; Mortier, L.; Leccia, M.T.; Dutriaux, C.; Dalac, S.; Montaudié, H.; de Quatrebarbes, J.; Brunet-Possenti, F.; Saiag, P.; Lesimple, T.; Beylot-Barry, M.; Aubin, F.; Stoebner, P.E.; Arnault, J.P.; Dreno, B.; Porcher, R.; Lebbé, C.; Guillot, B. Tolerance and Effectiveness of Targeted Therapies in Aged Patients with Metastatic Melanoma. Preprints 2021, 2021060460 (doi: 10.20944/preprints202106.0460.v1).

Abstract

Purpose: Melanoma’s incidence is increasing, and elderly people could be significantly impacted since the majority occurs in people over 65 years of age. Combined targeted therapies (TT) are current standard regimen for BRAF mutated metastatic melanoma (MM). Except for subgroups of pivotal trials, little data are available for TT in this population. Materials and Methods: Outcomes were explored in real life patients from MelBase, a French multicentric biobank dedicated to the prospective follow-up of unresectable stage III or IV melanoma. Patients treated by BRAF TT and/or MEK TT combined or not, were included from 2013 to 2017 in 2 groups: group 1 <65-year-old (yo), group 2 >65 yo, analyzed for tolerance and efficacy. Results: 353 patients were included: 231 in group 1, 122 in group 2. Median follow-up was 12 months (M). Median time of treatment was 6.9 M. A total of 80% had at least one Adverse Effect (AE). Most frequent AE (all grades) were mainly skin and subcutaneous, general, and gastrointestinal disorders. A total of 31% of AE were grade 3–4: 28% in group 1 and 39% in group 2 (p = 0.05). No differences were observed in all AE grades proportion, dose modifications, interruptions, and discontinuations. For each group, median overall survival was 20.3 M (CI 95%: 15.5–27.9) and 16.3 M (CI: 14.5–26.9), respectively (p = 0.8). Median progression free survival was 7.8 M (6.4–9.9) and 7.7 M (CI: 5.8–11.3) (p = 0.4). Objective response rate was 59% and 50% (p = 0.6). Conclusion: This study on a large multicentric cohort is the first to assess that TT is well tolerated in elderly BRAF-mutated patients such as in patients younger than 65. Efficacy was similar between groups with outcomes reaching those from pivotal studies. There is thus no argument against using TT in elderly people, although an onco-geriatric opinion is welcome for the most vulnerable.

Keywords

melanoma; targeted therapy; elderly people; side effects

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