Efficacy of salvage therapies for advanced acral melanoma after anti-PD-1 monotherapy failure: a multicenter retrospective study of 108 Japanese patients

被引：8

作者：

Mori, Tatsuhiko ^{[1
]}

Namikawa, Kenjiro ^{[2
]}

Yamazaki, Naoya ^{[2
]}

Kiniwa, Yukiko ^{[3
]}

Yamasaki, Osamu ^{[4
]}

Yoshikawa, Shusuke ^{[5
]}

Inozume, Takashi ^{[6
]}

Kato, Hiroshi ^{[7
]}

Nakai, Yasuo ^{[8
]}

Fukushima, Satoshi ^{[9
]}

Takenouchi, Tatsuya ^{[10
]}

Maekawa, Takeo ^{[11
]}

Matsushita, Shigeto ^{[12
]}

Otsuka, Atsushi ^{[13
,14
]}

Nomura, Motoo ^{[15
]}

Baba, Natsuki ^{[16
]}

Isei, Taiki ^{[17
]}

Saito, Shintaro ^{[18
]}

Fujimoto, Noriki ^{[19
]}

Tanaka, Ryo ^{[20
]}

Kaneko, Takahide ^{[21
]}

Kuwatsuka, Yutaka ^{[22
]}

Matsuya, Taisuke ^{[23
]}

Nagase, Kotaro ^{[24
]}

Onishi, Masazumi ^{[25
]}

Onuma, Takehiro ^{[26
]}

Nakamura, Yasuhiro ^{[1
]}

机构：

[1] Saitama Med Univ, Int Med Ctr, Dept Skin Oncol Dermatol, Saitama, Japan

[2] Natl Canc Ctr, Dept Dermatol Oncol, Tokyo, Japan

[3] Shinshu Univ, Dept Dermatol, Matsumoto, Japan

[4] Okayama Univ, Dept Dermatol Dent & Pharmaceut Sci, Grad Sch Med, Okayama, Japan

[5] Shizuoka Canc Ctr, Div Dermatol, Shizuoka, Japan

[6] Chiba Univ, Dept Dermatol, Chiba, Japan

[7] Nagoya City Univ, Grad Sch Med Sci, Dept Geriatr & Environm Dermatol, Nagoya, Japan

[8] Mie Univ, Dept Dermatol, Tsu, Mie 5148507, Japan

[9] Kumamoto Univ, Fac Life Sci, Dept Dermatol & Plast Surg, Kumamoto, Japan

[10] Niigata Canc Ctr Hosp, Dept Dermatol, Niigata, Japan

[11] Jichi Med Univ, Dept Dermatol, Shimotsuke, Tochigi, Japan

[12] Natl Hosp Org Kagoshima Med Ctr, Dept Dermatooncol Dermatol, Kagoshima, Japan

[13] Kyoto Univ, Dept Dermatol, Kyoto, Japan

[14] Kindai Univ Hosp, Dept Dermatol, Osaka, Japan

[15] Kyoto Univ, Dept Clin Oncol, Kyoto, Japan

[16] Univ Fukui, Dept Dermatol, Fukui, Japan

[17] Osaka Int Canc Inst, Dept Dermatol Oncol, Osaka, Japan

[18] Gunma Univ, Grad Sch Med, Dept Dermatol, Maebashi, Japan

[19] Shiga Univ Med Sci, Dept Dermatol, Otsu, Japan

[20] Kawasaki Med Sch, Dept Dermatol, Kurashiki, Okayama, Japan

[21] Juntendo Univ, Urayasu Hosp, Dept Dermatol, Chiba, Japan

[22] Nagasaki Univ Hosp, Dept Dermatol, Nagasaki, Japan

[23] Asahikawa Med Univ, Dept Dermatol, Asahikawa, Japan

[24] Saga Univ, Fac Med, Dept Internal Med, Div Dermatol, Saga, Japan

[25] Iwate Med Univ, Dept Dermatol, Morioka, Iwate, Japan

[26] Univ Yamanashi, Dept Dermatol, Yamanashi, Japan

来源：

FRONTIERS IN MEDICINE | 2023年 / 10卷

关键词：

melanoma; programmed cell death 1 receptor; immunotherapy; salvage therapy; nails; PEMBROLIZUMAB; PATHOLOGY; OUTCOMES;

D O I：

10.3389/fmed.2023.1229937

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Anti-programmed cell death protein 1 (PD-1) monotherapy is one of the standard systemic therapies for advanced melanoma; however, the efficacy of salvage systemic therapies after PD-1 monotherapy failure (PD-1 MF), particularly in acral melanoma (AM), the main clinical melanoma type in Japanese patients, is unclear. This study aimed to investigate the efficacy of salvage systemic therapies in Japanese patients with AM after PD-1 MF.Patients and methods The study included 108 patients with advanced AM (palm and sole, 72; nail apparatus, 36) who underwent salvage systemic therapy at 24 Japanese institutions. We mainly assessed the objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).Results Thirty-six (33%) patients received ipilimumab, 23 (21%) received nivolumab and ipilimumab (nivo/ipi), 10 (9%) received cytotoxic chemotherapy, 4 (4%) received BRAF and MEK inhibitors (BRAFi/MEKi), and the remaining 35 (32%) continued with PD-1 monotherapy after disease progression. The ORRs in the ipilimumab, nivo/ipi, cytotoxic chemotherapy, and BRAFi/MEKi groups were 8, 17, 0, and 100%, respectively. The nivo/ipi group showed the longest OS (median, 18.9 months); however, differences in ORR, PFS, and OS between the groups were insignificant. The OS in the nivo/ipi group was higher in the palm and sole groups than in the nail apparatus group (median: not reached vs. 8.7 months, p < 0.001). Cox multivariate analysis demonstrated that nail apparatus melanoma independently predicted unfavorable PFS and OS (p = 0.006 and 0.001). The total OS (from PD-1 monotherapy initiation to death/last follow-up) was insignificant between the groups.Conclusion Nivo/ipi was not more effective than cytotoxic chemotherapy and ipilimumab after PD-1 MF in patients with advanced AM. The prognosis after PD-1 MF would be poorer for nail apparatus melanoma than for palm and sole melanoma.

引用

页数：11

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