Outcomes of patients with resected stage III/IV acral or mucosal melanoma, treated with adjuvant anti-PD-1 based therapy

被引:6
作者
Jacques, Sarah K. [1 ,2 ]
McKeown, Janet [3 ]
Grover, Piyush [3 ]
Johson, Douglas B. [4 ]
Zaremba, Anne [5 ]
Dimitriou, Florentia [6 ,7 ]
Weiser, Roi [24 ]
Farid, Mohamad [8 ]
Namikawa, Kenjiro [9 ]
Sullivan, Ryan J. [10 ]
Rutkowski, Piotr [11 ]
Lebbe, Celeste [12 ]
Hamid, Omid [13 ]
Zager, Jonathan S. [14 ]
Michielin, Olivier [15 ]
Neyns, Bart [16 ]
Nakamura, Yasuhiro [17 ]
Robert, Caroline [18 ,19 ]
Mehnert, Janice [25 ]
Ascierto, Paolo A. [26 ]
Bhave, Prachi [23 ]
Park, Benjamin [4 ]
Zimmer, Lisa [5 ]
Mangana, Joanna [6 ,11 ]
Mooradian, Megan [10 ]
Placzke, Joanna [7 ]
Allayous, Clare [12 ]
Oliva, Isabella C. Glitza [24 ]
Mehmi, Inderjit [13 ]
Depalo, Danielle [14 ]
Wicky, Alexandre [15 ]
Schwarze, Julia K. [16 ]
Roy, Severine [18 ]
Boatwright, Christina [25 ]
Vanella, Vito [26 ]
Long, Georgina, V [3 ,20 ,21 ]
Menzies, Alexander M. [3 ,20 ,21 ,22 ]
Lo, Serigne N. [3 ,20 ]
Carlino, Matteo S. [1 ,2 ,3 ,27 ]
机构
[1] Westmead Hosp, Dept Med Oncol, Sydney, Australia
[2] Blacktown Hosp, Dept Med Oncol, Sydney, Australia
[3] Univ Sydney, Melanoma Inst Australia, Sydney, Australia
[4] Vanderbilt Univ, Med Ctr, Nashville, TN USA
[5] Univ Hosp Essen, Dept Dermatol Venereol & Allergol, Essen, Germany
[6] Univ Hosp Zurich, Dept Dermatol, Zurich, Switzerland
[7] Univ Zurich, Fac Med, Zurich, Switzerland
[8] Natl Canc Ctr, Singapore, Singapore
[9] Natl Canc Ctr, Dept Dermatol Oncol, Tokyo, Japan
[10] Harvard Univ, Massachusetts Gen Hosp, Boston, MA USA
[11] Maria Sklodowska Curie Natl Res Inst Oncol, Warsaw, Poland
[12] Univ Paris Cite, St Louis Hosp, Canc Inst AP HP Nord Paris Cite, INSERM U976,AP HP Dermatooncol, Paris, France
[13] Angeles Clin, Los Angeles, CA USA
[14] Moffit Canc Ctr, Dept Cutaneous Oncol, Tampa, FL USA
[15] Lausanne Univ Hosp, Dept Oncol, Lausanne, Switzerland
[16] Univ Ziekenhuis Brussel, Brussels, Belgium
[17] Saitama Med Univ, Comprehens Canc Ctr, Int Med Ctr, Dept Skin Oncol Dermatol, Saitama, Japan
[18] Inst Gustave Roussy, Villejuif, France
[19] Paris Saclay Univ, Villejuif, France
[20] Univ Sydney, Fac Med & Hlth, Sydney, Australia
[21] Royal North Shore Hosp, Sydney, Australia
[22] Mater Hosp, Sydney, Australia
[23] Univ Melbourne, Sir Peter MacCallum Canc Ctr, Dept Oncol, Melbourne, Vic, Australia
[24] MD Anderson Canc Ctr, Houston, TX USA
[25] NYU Langone, New York, NY USA
[26] Ist Nazl Tumori IRCCS Fdn Pascale, Naples, Italy
[27] Westmead Hosp, Crown Princess Mary Canc Ctr, 166-174 Hawkesbury Rd, Westmead, NSW 2145, Australia
基金
澳大利亚国家健康与医学研究理事会;
关键词
Acral melanoma; Mucosal melanoma; Adjuvant; Immunotherapy; Anti-PD1; IMMUNE CHECKPOINT INHIBITORS;
D O I
10.1016/j.ejca.2024.113563
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Importance: Acral (AM) and mucosal melanomas (MM) are rare subtypes with a poor prognosis. In those with advanced disease, anti-PD-1 (PD1) therapy has reduced activity compared to that seen in non-acral cutaneous melanoma. Objective: To determine the efficacy of adjuvant PD1 in resected AM or MM. Design: An international, retrospective cohort study Setting: Data up to November 2021 collected from 20 centres across 10 countries. Participants: One hundred and ninety four patients with resected stage III or IV1 AM or MM who received adjuvant PD1 were included and compared to matched patients from the Melanoma Institute Australia (MIA) database using a propensity score matching analysis. Main outcomes and measures: Recurrence -free survival (RFS), distant metastasis -free survival (DMFS) and overall survival (OS) were investigated. Results: Forty five of 139 (32%) AM and 9 of 55 (16%) MM patients completed adjuvant therapy. The main reason for early treatment cessation in both groups was disease recurrence: 51 (37%) and 30 (55%) in the AM and MM groups, respectively. In the AM group adjuvant PD1 was associated with a longer RFS [HR -0.69 (0.52-0.92, p = 0.0127)], DMFS [HR0.58 (0.38-0.89, p = 0.0134)] and OS [HR of 0.59 (0.38-0.92, p -value 0.0196)] when compared to the historical cohort. In the MM group there was no statistical difference in RFS [HR1.36 (0.69-2.68,p -value 0.3799], DMFS or OS. Conclusion and relevance: After adjuvant PD1, both AM and MM have a high risk of recurrence. Our data suggests a benefit to using adjuvant PD1 therapy in resected AM but not in resected MM. Additional studies to investigate the efficacy of adjuvant PD1 for MM are needed.
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页数:8
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