Top

Published in:

Open Access 01-06-2019 | Research Article

Health-related quality of life analysis in stage III melanoma patients treated with adjuvant dendritic cell therapy

Authors: M. Bloemendal, M. J. A. Rietveld, W. W. van Willigen, W. R. Gerritsen, C. G. Figdor, J. J. Bonenkamp, H. Westdorp, S. Boudewijns, R. H. T. Koornstra, E. M. M. Adang, G. Schreibelt, P. B. Ottevanger, I. J. M. de Vries, K. F. Bol

Published in: Clinical and Translational Oncology | Issue 6/2019

Abstract

Background

Health-related quality of life (HRQoL) is an important issue in the rapidly evolving field of adjuvant treatment for stage III melanoma. Dendritic cell vaccination is one of the adjuvant forms of therapy currently investigated.

Methods

We enrolled adults with stage III melanoma to receive adjuvant dendritic cell vaccination after a complete radical lymph node dissection. HRQoL assessment was one of the secondary endpoints of this trial and investigated with the EORTC-QLQ-C30 questionnaire at baseline and week 26.

Results

Fifteen patients with a median age of 50 years were included in the study, with twelve evaluable patients on study at time of the second questionnaire. Global health status and role functioning improved clinically relevant with a mean difference of 15 (p = 0.010) and 26 points (p = 0.005), respectively.

Discussion

Despite the small number of patients, we found a clinically relevant improved global health status. Besides, compared to the other investigated therapies, toxicity of dendritic cell vaccination is low, which supports our finding.

Conclusion

This is the first description of HRQoL in melanoma patients receiving dendritic cell vaccination. We show the expected improvement in global health status after surgical treatment of stage III melanoma. Thus, adjuvant dendritic cell vaccination does not seem to hamper this improvement, as shown in our small explorative study.

Erdmann F, Lortet-Tieulent J, Schuz J, Zeeb H, Greinert R, Breitbart EW, et al. International trends in the incidence of malignant melanoma 1953–2008—are recent generations at higher or lower risk? Int J Cancer. 2013;132(2):385–400. https://doi.org/10.1002/ijc.27616.CrossRefPubMed

Estimated number of incident cases, both sexes, melanoma of skin, worldwide. Cancer Today International Agency for Research on Cancer. https://gco.iarc.fr (2012). Accessed 9 Jan 2018.

Faries MB, Thompson JF, Cochran AJ, Andtbacka RH, Mozzillo N, Zager JS, et al. Completion dissection or observation for sentinel-node metastasis in melanoma. N Engl J Med. 2017;376(23):2211–22. https://doi.org/10.1056/NEJMoa1613210.CrossRefPubMedPubMedCentral

Balch CM, Gershenwald JE, Soong S-J, Thompson JF, Atkins MB, Byrd DR, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol. 2009;27(36):6199–206.CrossRefPubMedPubMedCentral

Henderson MA, Burmeister BH, Ainslie J, Fisher R, Di Iulio J, Smithers BM, et al. Adjuvant lymph-node field radiotherapy versus observation only in patients with melanoma at high risk of further lymph-node field relapse after lymphadenectomy (ANZMTG 01.02/TROG 02.01): 6-year follow-up of a phase 3, randomised controlled trial. Lancet Oncol. 2015;16(9):1049–60. https://doi.org/10.1016/S1470-2045(15)00187-4.CrossRefPubMed

Eggermont AM, Chiarion-Sileni V, Grob JJ, Dummer R, Wolchok JD, Schmidt H, et al. Prolonged survival in stage III melanoma with ipilimumab adjuvant therapy. N Engl J Med. 2016. https://doi.org/10.1056/nejmoa1611299.CrossRefPubMedPubMedCentral

Long GV, Hauschild A, Santinami M, Atkinson V, Mandala M, Chiarion-Sileni V, et al. Adjuvant dabrafenib plus trametinib in stage III BRAF-mutated melanoma. N Engl J Med. 2017. https://doi.org/10.1056/nejmoa1708539.CrossRefPubMedPubMedCentral

Weber J, Mandala M, Del Vecchio M, Gogas HJ, Arance AM, Cowey CL, et al. Adjuvant nivolumab versus ipilimumab in resected stage III or IV melanoma. N Engl J Med. 2017. https://doi.org/10.1056/nejmoa1709030.CrossRefPubMed

Eggermont AMM, Blank CU, Mandala M, Long GV, Atkinson V, Dalle S, et al. Adjuvant pembrolizumab versus placebo in resected stage III melanoma. N Engl J Med. 2018. https://doi.org/10.1056/nejmoa1802357.CrossRefPubMed

10.

Gajewski TF. Failure at the effector phase: immune barriers at the level of the melanoma tumor microenvironment. Clin Cancer Res. 2007;13(18 Pt 1):5256–61. https://doi.org/10.1158/1078-0432.CCR-07-0892.CrossRefPubMed

11.

Haydu LE, Scolyer RA, Lo S, Quinn MJ, Saw RPM, Shannon KF, et al. Conditional survival: an assessment of the prognosis of patients at time points after initial diagnosis and treatment of locoregional melanoma metastasis. J Clin Oncol. 2017;35(15):1721–9. https://doi.org/10.1200/JCO.2016.71.9393.CrossRefPubMed

12.

Anguille S, Smits EL, Lion E, van Tendeloo VF, Berneman ZN. Clinical use of dendritic cells for cancer therapy. Lancet Oncol. 2014;15(7):e257–67. https://doi.org/10.1016/S1470-2045(13)70585-0.CrossRefPubMed

13.

Draube A, Klein-Gonzalez N, Mattheus S, Brillant C, Hellmich M, Engert A, et al. Dendritic cell based tumor vaccination in prostate and renal cell cancer: a systematic review and meta-analysis. PLoS ONE. 2011;6(4):e18801. https://doi.org/10.1371/journal.pone.0018801.CrossRefPubMedPubMedCentral

14.

Leonhartsberger N, Ramoner R, Falkensammer C, Rahm A, Gander H, Holtl L, et al. Quality of life during dendritic cell vaccination against metastatic renal cell carcinoma. Cancer Immunol Immunother. 2012;61(9):1407–13. https://doi.org/10.1007/s00262-012-1207-7.CrossRefPubMed

15.

Burgdorf SK, Fischer A, Myschetzky PS, Munksgaard SB, Zocca MB, Claesson MH, et al. Clinical responses in patients with advanced colorectal cancer to a dendritic cell based vaccine. Oncol Rep. 2008;20(6):1305–11.PubMed

16.

Skold AE, van Beek JJ, Sittig SP, Bakdash G, Tel J, Schreibelt G, et al. Protamine-stabilized RNA as an ex vivo stimulant of primary human dendritic cell subsets. Cancer Immunol Immunother. 2015;64(11):1461–73. https://doi.org/10.1007/s00262-015-1746-9.CrossRefPubMedPubMedCentral

17.

Niezgoda HE, Pater JL. A validation-study of the domains of the core eortc quality-of-life questionnaire. Qual Life Res. 1993;2(5):319–25. https://doi.org/10.1007/Bf00449426.CrossRefPubMed

18.

Fayers PM. Interpreting quality of life data: population-based reference data for the EORTC QLQ-C30. Eur J Cancer. 2001;37(11):1331–4. https://doi.org/10.1016/S0959-8049(01)00127-7.CrossRefPubMed

19.

Osoba D, Rodrigues G, Myles J, Zee B, Pater J. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol. 1998;16(1):139–44.CrossRefPubMed

20.

King MT. The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Qual Life Res. 1996;5(6):555–67. https://doi.org/10.1007/Bf00439229.CrossRefPubMed

21.

Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A. EORTC QLQ-C30 scoring manual. 3rd ed. Brussels: The EORTC Quality of Life Group; 2001.

22.

Coens C, Suciu S, Chiarion-Sileni V, Grob JJ, Dummer R, Wolchok JD, et al. Health-related quality of life with adjuvant ipilimumab versus placebo after complete resection of high-risk stage III melanoma (EORTC 18071): secondary outcomes of a multinational, randomised, double-blind, phase 3 trial. Lancet Oncol. 2017;18(3):393–403. https://doi.org/10.1016/S1470-2045(17)30015-3.CrossRefPubMedPubMedCentral

23.

Bottomley A, Coens C, Suciu S, Santinami M, Kruit W, Testori A, et al. Adjuvant therapy with pegylated interferon alfa-2b versus observation in resected stage III melanoma: a phase III randomized controlled trial of health-related quality of life and symptoms by the European Organisation for Research and Treatment of Cancer Melanoma Group. J Clin Oncol. 2009;27(18):2916–23. https://doi.org/10.1200/JCO.2008.20.2069.CrossRefPubMed

24.

Garbe C, Radny P, Linse R, Dummer R, Gutzmer R, Ulrich J, et al. Adjuvant low-dose interferon {alpha}2a with or without dacarbazine compared with surgery alone: a prospective-randomized phase III DeCOG trial in melanoma patients with regional lymph node metastasis. Ann Oncol. 2008;19(6):1195–201. https://doi.org/10.1093/annonc/mdn001.CrossRefPubMed

25.

Lorigan P, Green AC. Immunotherapy: does adjuvant ipilimumab have little adverse effect on quality of life? Nat Rev Clin Oncol. 2017;14(7):395–6. https://doi.org/10.1038/nrclinonc.2017.60.CrossRefPubMed

26.

Peteet JR. Cancer and the meaning of work. Gen Hosp Psychiatry. 2000;22(3):200–5.CrossRefPubMed

27.

Mohr P, Hauschild A, Trefzer U, Enk A, Tilgen W, Loquai C, et al. Intermittent high-dose intravenous interferon alfa-2b for adjuvant treatment of stage III melanoma: final analysis of a randomized phase III dermatologic cooperative oncology group trial. J Clin Oncol. 2015;33(34):4077–84. https://doi.org/10.1200/JCO.2014.59.6932.CrossRefPubMed

Title: Health-related quality of life analysis in stage III melanoma patients treated with adjuvant dendritic cell therapy
Authors: M. Bloemendal
M. J. A. Rietveld
W. W. van Willigen
W. R. Gerritsen
C. G. Figdor
J. J. Bonenkamp
H. Westdorp
S. Boudewijns
R. H. T. Koornstra
E. M. M. Adang
G. Schreibelt
P. B. Ottevanger
I. J. M. de Vries
K. F. Bol
Publication date: 01-06-2019
Publisher: Springer International Publishing
Published in: Clinical and Translational Oncology / Issue 6/2019
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI: https://doi.org/10.1007/s12094-018-1987-0

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Discussion

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2019

Omitting the lower neck and sparing the glottic larynx in node-negative nasopharyngeal carcinoma was safe and feasible, and improved patient-reported voice outcomes

Metronomic oral vinorelbine for the treatment of advanced non-small cell lung cancer: a multicenter international retrospective analysis

The burden of cancer in Spain

The protective effects of melatonin on blood cell counts of rectal cancer patients following radio-chemotherapy: a randomized controlled trial

The dual effect of morphine on tumor development

Oncologic outcomes of nephron-sparing surgery in patients with T1 multifocal renal cell carcinoma

Keynote webinar | Spotlight on antibody–drug conjugates in cancer