Global practice patterns and outcomes for metastatic uveal melanoma treated regionally versus systemically.
Notice bibliographique
Résumé
e23324 Background: Due to the hepatotropic pattern of metastasis in uveal melanoma (UM), liver directed therapies (LDT) are commonly used for the treatment of advanced disease. The PUMMA meta-analysis (Khoja et al, 2019) assessed patients (pts) with metastatic UM (mUM) treated on trials conducted from 2000-2016 and suggested improved outcomes for those treated with LDT. Methods: Using data from 7 centers in the US, Canada, the UK and Australia collected between as part of the Ocular Melanoma Natural History (OMNi) study, we assessed this finding in a more contemporary dataset and investigated potential global variations in practice patterns. Analysis was performed on data entered as of May 2024. Results: Of 985 pts enrolled, 283 developed mUM and received at least 1 line of treatment (tx; 77-US; 160-Canada; 30-UK; 16-Australia). 164 received regional (R) tx (LDT, surgery, radiation; 41% US pts, 35% Canadian pts, 46% UK pts, 55% Australian pts), with 130 treated in the first-line (1L) setting. 212 received systemic (S) tx (51% US pts, 55% Canadian pts, 51% UK pts, 55% Australian pts), with 137 treated in the 1L setting. Concurrent (C; any R tx delivered while a S tx was ongoing) was administered in 50 patients (18% US pts, 10% of Canada pts, 3% UK, pts 5% Australian pts), with 16 treated in the 1L setting. At the time of 1L tx, median age was 63 (range, 25-92), 62 (range, 24-88), and 64 (range, 42-83) years for those treated with S, R, and C tx, respectively. 47%, 50% and 25% were female of those treated with S, R, and C tx, respectively. Mean diameter of the largest tumor lesion and percentage of cases with stage M1b/c disease at time of 1L tx were 1.5cm and 20%, 1.1cm and 19%, and 0.6 cm and 0% for those treated with S, R or C tx, respectively. There was no significant difference in proportion of patients with liver-only disease who received 1L S or R/C tx (61 vs 62%, respectively). Median overall survival (OS) was 32, 24 and 32 months for those treated with S, R or C tx, respectively, with no significant difference observed across groups (p = 0.09). Conclusions: The use of C tx was more common in the US and Canadian centers when compared with those in the UK and Australia. Patient and tumor characteristics were similar between those treated with 1L S and R therapies, with no difference in OS observed in this dataset based upon initial tx strategy. Clinical trial information: NCT04588662 . Therapy Pts Receiving 1L Systemic Therapy (n = 137) Pts Receiving 1L Regional Therapy (n = 130) Pts Receiving 1L Concurrent Therapy (n = 16) Systemic Regional Checkpoint Blockade 104 (76%) n/a 10 (62%) n/a Targeted Therapy 22 (16%) n/a 6 (38%) n/a Other Systemic Therapy 11 (8%) n/a 0 (0%) n/a Surgery or Radiofrequency Ablation n/a 62 (48%) n/a 3 (18%) Radiotherapy n/a 22 (17%) n/a 4 (25%) Other Liver Directed Therapy n/a 34 (26%) n/a 6 (38%) Radioembolization or Chemoembolization n/a 9 (7%) n/a 2 (12%) Percutaneous Hepatic Perfusion n/a 3 (2%) n/a 1 (6%)
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,014 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».