Systemic Therapy in Advanced Nodular Melanoma versus Superficial Spreading Melanoma: A Nation-Wide Study of the Dutch Melanoma Treatment Registry

Autor: Daan Jan Willem Rauwerdink, Remco van Doorn, Jos van der Hage, Alfonsus J. M. Van den Eertwegh, John B. A. G. Haanen, Maureen Aarts, Franchette Berkmortel, Christian U. Blank, Marye J. Boers-Sonderen, Jan Willem B. De Groot, Geke A. P. Hospers, Melissa de Meza, Djura Piersma, Rozemarijn S. Van Rijn, Marion Stevense, Astrid Van der Veldt, Gerard Vreugdenhil, Michel W. J. M. Wouters, Karijn Suijkerbuijk, Monique van der Kooij, Ellen Kapiteijn
Přispěvatelé: Interne Geneeskunde, MUMC+: MA Medische Oncologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Internal medicine, Medical oncology, AII - Cancer immunology, CCA - Cancer Treatment and quality of life, Obstetrics and gynaecology, Medical Oncology, Radiology & Nuclear Medicine
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Cancers, 14(22):5694. Multidisciplinary Digital Publishing Institute (MDPI)
Cancers; Volume 14; Issue 22; Pages: 5694
Cancers, 14(22):5694. MDPI AG
Cancers, 14(22). MDPI
Rauwerdink, D J W, van Doorn, R, van der Hage, J, van den Eertwegh, A J M, Haanen, J B A G, Aarts, M, Berkmortel, F, Blank, C U, Boers-Sonderen, M J, de Groot, J W B, Hospers, G A P, de Meza, M, Piersma, D, van Rijn, R S, Stevense, M, van der Veldt, A, Vreugdenhil, G, Wouters, M W J M, Suijkerbuijk, K, van der Kooij, M & Kapiteijn, E 2022, ' Systemic Therapy in Advanced Nodular Melanoma versus Superficial Spreading Melanoma : A Nation-Wide Study of the Dutch Melanoma Treatment Registry ', Cancers, vol. 14, no. 22, 5694 . https://doi.org/10.3390/cancers14225694
Cancers, 14, 22
Cancers, 14
ISSN: 2072-6694
DOI: 10.3390/cancers14225694
Popis: Simple Summary Nodular melanoma is associated with a higher locoregional recurrence rate and worse overall survival outcomes. Whether this histologic subtype affects the efficacy of immunotherapy or targeted therapy is unclear. The aim of our multi-center nationwide study is to identify the efficacy of immunotherapy and BRAF/MEKi therapy in metastatic nodular melanoma compared with the efficacy in metastatic superficial spreading melanoma. Our study results demonstrate no difference between the effectiveness of immunotherapy and BRAF/MEKi in metastatic nodular versus superficial melanoma patients. A shorter distant metastasis-free survival and reduced overall survival (measured as the time between primary melanoma up to death or last follow-up) was observed in the nodular melanoma patient group, suggesting worse overal survival of nodular melanoma is mainly driven by propensity of metastatic outgrowth of nodular melanoma after primary diagnosis. Nodular melanoma (NM) is associated with a higher locoregional and distant recurrence rate compared with superficial spreading melanoma (SSM); it is unknown whether the efficacy of systemic therapy is limited. Here, we compare the efficacy of immunotherapy and BRAF/MEK inhibitors (BRAF/MEKi) in advanced NM to SSM. Patients with advanced stage IIIc and stage IV NM and SSM treated with anti-CTLA-4 and/or anti-PD-1, or BRAF/MEKi in the first line, were included from the prospective Dutch Melanoma Treatment Registry. The primary objectives were distant metastasis-free survival (DMFS) and overall survival (OS). In total, 1086 NM and 2246 SSM patients were included. DMFS was significantly shorter for advanced NM patients at 1.9 years (CI 95% 0.7-4.2) compared with SSM patients at 3.1 years (CI 95% 1.3-6.2) (p < 0.01). Multivariate survival analysis for immunotherapy and BRAF/MEKi demonstrated a hazard ratio for immunotherapy of 1.0 (CI 95% 0.85-1.17) and BRAF/MEKi of 0.95 (CI 95% 0.81-1.11). A shorter DMFS for NM patients developing advanced disease compared with SSM patients was observed, while no difference was observed in the efficacy of systemic immunotherapy or BRAF/MEKi between NM and SSM patients. Our results suggests that the worse overall survival of NM is mainly driven by propensity of metastatic outgrowth of NM after primary diagnosis.
Databáze: OpenAIRE
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