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Title: Overall Survival Benefit with Tebentafusp in Metastatic Uveal Melanoma
Author: Nathan, Paul
Hassel, Jessica C.
Rutkowski, Piotr
Baurain, Jean-Francois
Butler, Marcus O.
Schlaak, Max
Sullivan, Ryan J.
Ochsenreither, Sebastian
Dummer, Reinhard
Kirkwood, John M.
Joshua, Anthony M.
Sacco, Joseph J.
Shoushtari, Alexander N.
Orloff, Marlana
Piulats, Josep M.
Milhem, Mohammed
Salama, April K.S.
Curti, Brendan
Demidov, Lev
Gastaud, Lauris
Mauch, Cornelia
Yushak, Melinda
Carvajal, Richard D.
Hamid, Omid
Abdullah, Shaad E.
Holland, Chris
Goodall, Howard
Piperno-Neumann, Sophie
Keywords: Oftalmopaties
Issue Date: 23-Sep-2021
Publisher: Massachusetts Medical Society
Abstract: Background: Uveal melanoma is a disease that is distinct from cutaneous melanoma, with a low tumor mutational burden and a 1-year overall survival of approximately 50% in patients with metastatic uveal melanoma. Data showing a proven overall survival benefit with a systemic treatment are lacking. Tebentafusp is a bispecific protein consisting of an affinity-enhanced T-cell receptor fused to an anti-CD3 effector that can redirect T cells to target glycoprotein 100-positive cells. Methods: In this open-label, phase 3 trial, we randomly assigned previously untreated HLA-A*02:01-positive patients with metastatic uveal melanoma in a 2:1 ratio to receive tebentafusp (tebentafusp group) or the investigator's choice of therapy with single-agent pembrolizumab, ipilimumab, or dacarbazine (control group), stratified according to the lactate dehydrogenase level. The primary end point was overall survival. Results: A total of 378 patients were randomly assigned to either the tebentafusp group (252 patients) or the control group (126 patients). Overall survival at 1 year was 73% in the tebentafusp group and 59% in the control group (hazard ratio for death, 0.51; 95% confidence interval [CI], 0.37 to 0.71; P<0.001) in the intention-to-treat population. Progression-free survival was also significantly higher in the tebentafusp group than in the control group (31% vs. 19% at 6 months; hazard ratio for disease progression or death, 0.73; 95% CI, 0.58 to 0.94; P = 0.01). The most common treatment-related adverse events in the tebentafusp group were cytokine-mediated events (due to T-cell activation) and skin-related events (due to glycoprotein 100-positive melanocytes), including rash (83%), pyrexia (76%), and pruritus (69%). These adverse events decreased in incidence and severity after the first three or four doses and infrequently led to discontinuation of the trial treatment (2%). No treatment-related deaths were reported. Conclusions: Treatment with tebentafusp resulted in longer overall survival than the control therapy among previously untreated patients with metastatic uveal melanoma. (Funded by Immunocore; number, NCT03070392; EudraCT number, 2015-003153-18.). Copyright © 2021 Massachusetts Medical Society.
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It is part of: New England Journal of Medicine, 2021, vol. 385, num. 13, p. 1196-1206
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ISSN: 1533-4406
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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