Atopy improves survival and decreases risk of brain metastasis in cutaneous melanoma.
| Autor: | Neff C; Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA., Price M; Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA., Cioffi G; Trans Divisional Research Program (TDRP) Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Bethesda, MD, USA., Liu Z; Department of Biostatistics, Duke University School of Medicine, Durham, NC, USA., Walsh R; Department of Dermatology, Duke University School of Medicine, Durham, NC, USA., Barnholtz-Sloan JS; Department of Biostatistics, Duke University School of Medicine, Durham, NC, USA.; Center for Biomedical Informatics & Information Technology (CBIIT), National Cancer Institute, Bethesda, MD, USA., Walsh KM; Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA.; The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA.; Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA., Salama AKS; Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA.; Department of Medicine, Duke University Medical Center, Durham, NC, USA., Anders CK; Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA.; Department of Medicine, Duke University Medical Center, Durham, NC, USA., Fecci PE; Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA.; The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA.; Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA., Ostrom QT; Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA.; The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA.; Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA. |
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| Jazyk: | angličtina |
| Zdroj: | MedRxiv : the preprint server for health sciences [medRxiv] 2024 May 15. Date of Electronic Publication: 2024 May 15. |
| DOI: | 10.1101/2024.05.15.24307061 |
| Abstrakt: | Importance: Development of new therapies in melanoma has increased survival, and as a result more patients are living to develop brain metastasis (BrM). Identifying patients at increased risk of BrM is therefore of significant public health importance. Objective: To determine whether history of atopy is associated with improved survival or reduced incidence of BrM in cutaneous melanoma. Design: A retrospective cohort study conducted from June 2022 to March 2024. Setting: Population-based in states with Surveillance, Epidemiology and End Results (SEER) supported cancer registries. Participants: Individuals (≥65 years) diagnosed with cutaneous melanoma between January 1, 2008 and December 31, 2017 that are participants in traditional Medicare. Exposures: Individuals were compared that had history of atopy (allergic rhinitis, atopic dermatitis, asthma, and/or allergic/atopic conjunctivitis) diagnosed prior to melanoma diagnosis, ascertained using ICD-9 or ICD-10 codes in Medicare claims. Main Outcomes and Measures: Primary endpoints were diagnosis with a BrM or death during the follow-up period. Associations between atopy and endpoints were assessed using cox proportional hazards models to estimate hazard ratios (HR) and p-values. Results: A total of 29,956 cutaneous melanoma cases were identified (median age 76, 60% male and 97% non-Hispanic White). Overall, 7.1% developed BrM during follow up. Among the 35% that had history of atopy, the most common condition was atopic dermatitis (19%). After adjustment for demographic and prognostic factors, atopy was associated with a 16% decrease in death (HR=0.84 [95%CI:0.80-0.87], p Conclusions and Relevance: Atopy, particularly atopic dermatitis, was significantly associated with improved survival and decreased incidence of BrM. The improved survival associated with these conditions in the context of immunotherapy suggests that these conditions in the elderly may identify those with more robust immune function that may be more responsive to treatment. Competing Interests: AKSS: Research funding (paid to institution): Ascentage, Bristol Myers Squibb, Ideaya, Immunocore, Merck, Olatec Therapeutics, Regeneron, Replimune, Seagen. Consultant or advisory role: Bristol Myers Squibb, Iovance, Regeneron, Novartis, Pfizer. JSB-S is a full-time paid employee of the NIH/NCI. Gino Cioffi is a full-time contractor of the NIH/NCI. |
| Databáze: | MEDLINE |
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