Response to immune checkpoint inhibitors in acral melanoma: A nationwide cohort study

被引:24
|
作者
van Not, Olivier J. [1 ,2 ]
de Meza, Melissa M. [1 ,3 ,4 ]
van den Eertwegh, Alfons J. M. [5 ]
Haanen, John B. [6 ]
Blank, Christian U. [6 ,7 ]
Aarts, Maureen J. B. [8 ]
van den Berkmortel, Franchette W. P. J. [9 ]
van Breeschoten, Jesper [1 ,5 ]
de Groot, Jan-Willem B. [10 ]
Hospers, Geke A. P. [11 ]
Ismail, Rawa K. [1 ,12 ]
Kapiteijn, Ellen [13 ]
Piersma, Djura [14 ]
van Rijn, Roos S. [15 ]
Stevense-den Boer, Marion A. M. [16 ]
van der Veldt, Astrid A. M. [17 ]
Vreugdenhil, Gerard [18 ]
Bonenkamp, Han J. [19 ]
Boers-Sonderen, Marye J. [20 ]
Blokx, Willeke A. M. [21 ]
Wouters, Michel W. J. M. [1 ,3 ,4 ]
Suijkerbuijk, Karijn P. M. [2 ]
机构
[1] Dutch Inst Clin Auditing, Sci Bur, Rijnsburgerweg 10, NL-2333 AA Leiden, Netherlands
[2] Univ Med Ctr Utrecht, Dept Med Oncol, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands
[3] Netherlands Canc Inst, Dept Surg Oncol, Plesmanlaan 121, NL-1066 CX Amsterdam, Netherlands
[4] Leiden Univ, Dept Biomed Data Sci, Med Ctr, NL-2333 ZC Leiden, Netherlands
[5] Vrije Univ Amsterdam Med Ctr, Canc Ctr Amsterdam, Dept Med Oncol, Amsterdam UMC, De Boelelaan 1118, NL-1081 HZ Amsterdam, Netherlands
[6] Netherlands Canc Inst, Dept Mol Oncol & Immunol, Plesmanlaan 121, NL-1066 CX Amsterdam, Netherlands
[7] Netherlands Canc Inst, Dept Med Oncol & Immunol, Plesmanlaan 121, NL-1066 CX Amsterdam, Netherlands
[8] Maastricht Univ, GROW Sch Oncol & Dev Biol, Dept Med Oncol, Med Ctr, P Debyelaan 25, NL-6229 HX Maastricht, Netherlands
[9] Zuyderland Med Ctr Sittard, Dept Med Oncol, Dr H van der Hoffpl 1, NL-6162 BG Sittard Geleen, Netherlands
[10] Isala Oncol Ctr, Dokter van Heesweg 2, NL-8025 AB Zwolle, Netherlands
[11] Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Hanzepl 1, NL-9713 GZ Groningen, Netherlands
[12] Utrecht Inst Pharmaceut Sci, Div Pharmacoepidemiol & Clin Pharmacol, Utrecht, Netherlands
[13] Leiden Univ, Dept Med Oncol, Med Ctr, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands
[14] Med Spectrum Twente, Dept Internal Med, Koningspl 1, NL-7512 KZ Enschede, Netherlands
[15] Med Ctr Leeuwarden, Dept Internal Med, Henri Dunantweg 2, NL-8934 AD Leeuwarden, Netherlands
[16] Amphia Hosp, Dept Internal Med, Molengracht 21, NL-4818 CK Breda, Netherlands
[17] Erasmus MC, Dept Med Oncol & Radiol & Nucl Med, S Gravendijkwal 230, NL-3015 CE Rotterdam, Netherlands
[18] Maxima Med Ctr, Dept Internal Med, Run 4600, NL-5504 DB Eindhoven, Netherlands
[19] Radboud Univ Nijmegen, Dept Surg, Med Ctr, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands
[20] Radboud Univ Nijmegen, Dept Med Oncol, Med Ctr, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands
[21] Univ Med Ctr Utrecht, Dept Pathol, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands
关键词
Melanoma; Immune checkpoint inhibitors; Immunotherapy; Response; Survival; MUCOSAL; KIT; IPILIMUMAB; EFFICACY; SUBTYPES; OUTCOMES; THERAPY; ARM;
D O I
10.1016/j.ejca.2022.02.026
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Recent reports suggest the limited efficacy of immune checkpoints inhibitors in advanced acral melanoma (AM). This study aims to investigate the clinical outcomes of immune checkpoint inhibitors in patients with stage III and IV AM and compare them to cutaneous melanoma (CM). Methods: We included patients with advanced AM and CM treated with first-line anti -programmed cell death (PD)-1 monotherapy or ipilimumab-nivolumab registered in the prospective nationwide Dutch Melanoma Treatment Registry. Objective response rates, progression free survival (PFS) and overall survival (OS) were calculated. A Cox proportional hazard model was used to assess the prognostic factors with PFS and OS. Results: In total, 2058 patients (88 AM and 1970 CM) with advanced melanoma were included. First-line objective response rates were 34% for AM versus 54% for CM in the advanced anti-PD-1 cohort and 33% for AM versus 53% for CM in the advanced ipilimumab-nivolumab cohort. The Median PFS was significantly shorter for anti-PD-1 treated AM patients (3.1 months; 95%CI: 2.8-5.6) than patients with CM (10.1 months; 95%CI: 8.5-12.2) (P < 0.001). In patients with advanced melanoma, AM was significantly associated with a higher risk of progression (HRadj 1.63; 95%CI: 1.26-2.11 ; P < 0.001) and death (HRadj 1.54; 95%CI: 1.15-2.06; P Z 0.004) than CM. Conclusions: This study shows lower effectiveness of anti-PD-1 monotherapy and ipilimumab-nivolumab in AM, with lower response rates, PFS and OS than CM. This group of patients should be prioritised in the development of alternative treatment strategies. 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
引用
收藏
页码:70 / 80
页数:11
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