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

Autor: Bloem M; Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.; Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, The Netherlands.; Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands., van Not OJ; Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.; Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Aarts MJB; Department of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands., van den Berkmortel FWPJ; Department of Medical Oncology, Zuyderland Medical Centre Sittard, Sittard-Geleen, The Netherlands., Blank CU; Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Blokx WAM; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands., Boers-Sonderen MJ; Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands., Bonenkamp JJ; Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands., de Groot JB; Isala Oncology Center, Zwolle, The Netherlands., Haanen JB; Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Hospers GAP; Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands., Kapiteijn EW; Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands., de Meza MM; Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.; Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, The Netherlands.; Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Piersma D; Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands., van Rijn RS; Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands., Stevense-den Boer MAM; Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands., van der Veldt AAM; Department of Medical Oncology, Erasmus Medical Centre, Rotterdam, The Netherlands.; Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands., Vreugdenhil G; Department of Internal Medicine, Maxima Medical Centre, Eindhoven, The Netherlands., van den Eertwegh AJM; Department of Medical Oncology, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands., Suijkerbuijk KPM; Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Wouters MWJM; Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.; Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, The Netherlands.; Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: International journal of cancer [Int J Cancer] 2024 Oct 15; Vol. 155 (8), pp. 1455-1465. Date of Electronic Publication: 2024 Jun 24.
DOI: 10.1002/ijc.35060
Abstrakt: 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 (HR adj 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.
(© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)
Databáze: MEDLINE
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