Adjuvant treatment with anti-PD-1 in acral melanoma: A nationwide study

被引：5

作者：

Bloem, Manja ^{[1
,2
,3
]}

van Not, Olivier J. ^{[1
,4
]}

Aarts, Maureen J. B. ^{[5
]}

van den Berkmortel, Franchette W. P. J. ^{[6
]}

Blank, Christian U. ^{[7
]}

Blokx, Willeke A. M. ^{[8
]}

Boers-Sonderen, Marye J. ^{[9
]}

Bonenkamp, Johannes J. ^{[10
]}

de Groot, Jan-Willem B. ^{[11
]}

Haanen, John B. ^{[7
]}

Hospers, Geke A. P. ^{[12
]}

Kapiteijn, Ellen W. ^{[13
]}

de Meza, Melissa M. ^{[1
,2
,3
]}

Piersma, Djura ^{[14
]}

van Rijn, Rozemarijn S. ^{[15
]}

Stevense-den Boer, Marion A. M. ^{[16
]}

van Der Veldt, Astrid A. M. ^{[17
,18
]}

Vreugdenhil, Gerard ^{[19
]}

van den Eertwegh, Alfons J. M. ^{[20
]}

Suijkerbuijk, Karijn P. M. ^{[4
]}

Wouters, Michel W. J. M. ^{[1
,2
,3
]}

机构：

[1] Dutch Inst Clin Auditing, Sci Bur, Leiden, Netherlands

[2] Leiden Univ Med Ctr, Dept Biomed Data Sci, Einthovenweg 20, NL-2333 ZC Leiden, Netherlands

[3] Netherlands Canc Inst, Dept Surg Oncol, Amsterdam, Netherlands

[4] Univ Utrecht, Univ Med Ctr Utrecht, Dept Med Oncol, Utrecht, Netherlands

[5] Maastricht Univ Med Ctr, GROW Sch Oncol & Dev Biol, Dept Med Oncol, Maastricht, Netherlands

[6] Zuyderland Med Ctr Sittard, Dept Med Oncol, Geleen, Netherlands

[7] Netherlands Canc Inst, Dept Med Oncol & Immunol, Amsterdam, Netherlands

[8] Univ Med Ctr Utrecht, Dept Pathol, Utrecht, Netherlands

[9] Radboud Univ Nijmegen, Dept Med Oncol, Med Ctr, Nijmegen, Netherlands

[10] Radboud Univ Nijmegen, Dept Surg, Med Ctr, Nijmegen, Netherlands

[11] Isala Oncol Ctr, Zwolle, Netherlands

[12] Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands

[13] Leiden Univ Med Ctr, Dept Med Oncol, Leiden, Netherlands

[14] Med Spectrum Twente, Dept Internal Med, Enschede, Netherlands

[15] Med Ctr Leeuwarden, Dept Internal Med, Leeuwarden, Netherlands

[16] Amphia Hosp, Dept Internal Med, Breda, Netherlands

[17] Erasmus MC, Dept Med Oncol, Rotterdam, Netherlands

[18] Erasmus MC, Dept Radiol & Nucl Med, Rotterdam, Netherlands

[19] Maxima Med Ctr, Dept Internal Med, Eindhoven, Netherlands

[20] Vrije Univ Amsterdam, Canc Ctr Amsterdam, Dept Med Oncol, Amsterdam UMC,Med Ctr, Amsterdam, Netherlands

来源：

INTERNATIONAL JOURNAL OF CANCER | 2024年 / 155卷 / 08期

关键词：

acral melanoma; adjuvant; immune checkpoint inhibitors; immunotherapy; melanoma; METASTATIC MELANOMA; MUTATIONAL BURDEN; STAGE-III; IPILIMUMAB; SURVIVAL; NIVOLUMAB;

D O I：

10.1002/ijc.35060

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Previous studies demonstrated limited efficacy of immune checkpoint inhibitors in unresectable acral melanoma (AM); it remains unclear how this translates to the adjuvant setting. This study investigates clinical outcomes of acral compared to cutaneous melanoma (CM) patients treated with adjuvant anti-PD-1 after complete resection. All stages III-IV AM and CM patients receiving adjuvant anti-PD-1 after complete resection between 2018 and 2022 were included from the prospective nationwide Dutch Melanoma Treatment Registry. We analyzed recurrence-free survival (RFS), distant metastasis-free survival (DMFS), and overall survival (OS). A multivariable Cox regression analysis of RFS was performed to adjust for potential confounders. We included 1958 (86 AM and 1872 CM) patients. At baseline, AM patients more frequently had KIT mutations, higher disease stages, and Eastern Cooperative Oncology Group Performance Status, and fewer BRAF and NRAS mutations. Median RFS was 14.8 months (95% confidence interval [CI]: 11.5-29.3) in AM and 37.4 months (95% CI: 34.6 to not reached) in CM (p = .002). After correcting for potential confounders, AM remained associated with a higher risk of recurrence (HRadj 1.53; 95% CI: 1.07-2.17; p = .019). Two-year DMFS tended to be worse for AM than for CM: 64.5% versus 79.7% (p = .050). Two-year OS was significantly lower in AM (71.5% vs. 84.3%; p = .027). The results of this study suggest a poorer outcome of adjuvant-treated AM compared to CM. Studies assessing the added value of adjuvant treatment in AM are needed. Future research should investigate alternative treatment strategies to improve outcomes of high-risk AM.

引用

页码：1455 / 1465

页数：11

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