Dr Nathan on Updated Survival Outcomes With Tebentafusp in Metastatic Uveal Melanoma

Paul D. Nathan, MBBS, PhD, FRCP, consultant medical oncologist, Mount Vernon Cancer Centre, discusses the 3-year survival data from the phase 3 IMCgp100-202 trial (NCT03070392) of tebentafusp-tebn (Kimmtrak) in patients with previously untreated, HLA-A*02:01–positive metastatic uveal melanoma.

The randomized, open-label IMCgp100-202 study randomly assigned patients with metastatic uveal melanoma to receive tebentafusp vs the investigator's choice of pembrolizumab (Keytruda), ipilimumab (Yervoy) or dacarbazine.

Previously reported data from the primary analysis of the trial, which focused on previously untreated patients, showed that tebentafusp improved OS compared with the investigator's choice of treatment, with a hazard ratio (HR) of 0.51.

Updated data showed that after a minimum follow-up of 36 months, the estimated 3-year OS rate for tebentafusp was 21.6% vs 16.9% in the control arm, Nathan reports. The updated stratified HR was 0.68 in favor or tebentafusp, he adds. Moreover, prolonged survival benefit was consistently observed among patients with poor prognostic factors in the metastatic setting. Tebentafusp also maintained superior 1– and 2-year progression-free survival (PFS) rate vs the control. Notably, a third of tebentafusp responders were still experiencing responses at the 18-month mark. Disease control rates were 46% with tebentafusp and 27% with the investigator's choice of therapy, Nathan states.

Furthermore, the analysis showed that 37% of patients treated with tebentafusp experienced a greater than 50% reduction in circulating tumor DNA (ctDNA) by week 9. These patients experienced longer OS compared with those who did not experience early ctDNA clearance.

Overall, the agent was shown to prolong and maintain OS benefit, confirming its utility as a standard of care in the first line for this population.