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Melanoma

Melanoma Poster Presentations 1

P38: Salvage Metastasectomy after Adoptive Cell Transfer for Melanoma: Long-Term Updates

Thursday, March 21, 2024
10:01am – 10:07am ET
Location: C110
Introduction: Adoptive cell transfer (ACT) can mediate durable regressions in patients with metastatic melanoma. A subset of patients who initially respond to ACT will experience oligoprogression and are potential candidates for salvage metastasectomy. The durability of this intervention for long-term control of metastatic disease has not yet been evaluated.


Methods: Patients with metastatic melanoma who underwent ACT at a single institution from 2000-2022 were retrospectively reviewed for post-ACT interventions. Eligible patients had an objective response (by RECIST) to ACT or stable disease (SD) for at least 6 months before experiencing oligoprogression (in 1-3 sites) managed with metastasectomy. The primary outcomes were recurrence-free survival (RFS) and overall survival (OS) after salvage metastasectomy with an exploratory analysis for clinicopathologic factors associated with PFS and OS.


Results: 146 patients with metastatic melanoma treated with ACT had an objective response or SD for at least 6 months before experiencing disease progression. Of these, 30 (21%) had oligoprogression managed with metastasectomy. With a median follow-up of 80 months (range, 5 to 248 months), median OS was not reached and median RFS was 10.5 months. Ten-year OS rate was 54.7% and reached a plateau after 6 years.


Conclusions: A significant subset of patients who initially respond to ACT will experience oligoprogression. In highly selected patients with oligoprogression after ACT, metastasectomy was an effective therapeutic strategy that resulted in durable RFS and OS. Additional elements of initial immunologic response to ACT and clinicopathologic factors that predict optimal response to salvage metastasectomy remain to be elucidated.

Learning Objectives:

  • Understand the indications of metastasectomy after ACT immunotherapy in metastatic melanoma.
  • Understand the success of metastasectomy after ACT immunotherapy in metastatic melanoma.
  • Understand the heterogeneity of ACT immunotherapy responses and their implications in directing future interventions for patients with metastatic melanoma.