Adjuvant sunitinib confers overall survival advantage in primary uveal melanoma
The use of sunitinib in the adjuvant setting improves overall survival in high-risk patients with primary uveal melanoma, a study has found.
Using data from the Wills Eye Hospital Oncology Service Uveal Melanoma Cytogenetic Database, researchers identified 54 uveal melanoma patients (median age 56 years; 48 percent male) who received adjuvant sunitinib for 6 months, and 74 controls (median age 62 years; 48 percent male) presenting the same risk factors.
Inclusion criteria were monosomy 3 and 8q amplification by cytogenetic or DecisionDx-UM Class 2, and monosomy 3 and large tumour size (T3 to 4).
Compared with controls, sunitinib-treated patients had worse cytogenetic or molecular features (monosomy 3 and 8q amplification or class 2, 87 vs 57 percent; p<0.001), had smaller tumour sizes (T3 to 4 56 vs 83 percent; p=0.001) and were younger.
A total of 51 deaths were reported over a median follow-up of 52.7 months, including 14 (26 percent) in the sunitinib group and 37 (50 percent) in the control group.
In a univariate Cox proportional hazards model, the primary endpoint of overall survival was longer in the sunitinib group vs controls (hazard ratio, 0.53; 95 percent CI, 0.29 to 0.99; p=0.041). Adjusting for potential confounders, a significant interaction between use of sunitinib and age was detected (p=0.003).
Significant predictors of overall survival included cytogenetic/molecular status (p=0.015), T-size category (p=0.022), gender (p=0.040) and use of adjuvant sunitinib in patients aged <60 years (p=0.004). Results were confirmed by propensity score analysis.