BACKGROUND: Anti-programmed cell death protein 1 (PD-1) antibodies are a standard treatment for metastatic melanoma patients. However, the understanding of the efficacy of anti-PD-1 for acral melanoma (AM) and mucosal melanoma (MM) is limited as these subtypes are relatively rare compared to cutaneous melanoma (CM). METHODS: This single institution, retrospective cohort study included patients with advanced AM and MM who underwent anti-PD-1 therapy for metastatic melanoma between 2012 and 2018. Objective responses were determined using the investigator-assessed Response Evaluation Criteria in Solid Tumors version 1.1. Progression-free survival (PFS) and overall survival (OS) were assessed using the Kaplan-Meier method. A Cox regression analysis was performed to identify the factors associated with survival outcomes. RESULTS: Ninety-seven patients were identified, 38 (39%) with AM and 59 (61%) with MM. The objective response rates (ORRs) were 21.0% and 15.2% in patients with AM and MM, respectively. The median PFS and OS were 3.6 and 25.7 months for AM patients, and 3.0 and 20.1 months for MM patients, respectively. Elevated serum lactate dehydrogenase (LDH) (AM: hazard ratio [HR], 0.22; 95% confidence interval [CI], 0.06-0.87; p = 0.03, MM: HR, 0.20; 95% CI, 0.08-0.53; p = 0.001) was significantly associated with shorter OS for both subtypes. CONCLUSIONS: The ORR, PFS, and OS with anti-PD-1 therapy were poor in patients with AM and MM compared to those previously reported clinical trials for nonacral CM. High serum LDH was associated with significantly shorter OS.
BACKGROUND: Anti-programmed cell death protein 1 (PD-1) antibodies are a standard treatment for metastatic melanomapatients. However, the understanding of the efficacy of anti-PD-1 for acral melanoma (AM) and mucosal melanoma (MM) is limited as these subtypes are relatively rare compared to cutaneous melanoma (CM). METHODS: This single institution, retrospective cohort study included patients with advanced AM and MM who underwent anti-PD-1 therapy for metastatic melanoma between 2012 and 2018. Objective responses were determined using the investigator-assessed Response Evaluation Criteria in Solid Tumors version 1.1. Progression-free survival (PFS) and overall survival (OS) were assessed using the Kaplan-Meier method. A Cox regression analysis was performed to identify the factors associated with survival outcomes. RESULTS: Ninety-seven patients were identified, 38 (39%) with AM and 59 (61%) with MM. The objective response rates (ORRs) were 21.0% and 15.2% in patients with AM and MM, respectively. The median PFS and OS were 3.6 and 25.7 months for AM patients, and 3.0 and 20.1 months for MM patients, respectively. Elevated serum lactate dehydrogenase (LDH) (AM: hazard ratio [HR], 0.22; 95% confidence interval [CI], 0.06-0.87; p = 0.03, MM: HR, 0.20; 95% CI, 0.08-0.53; p = 0.001) was significantly associated with shorter OS for both subtypes. CONCLUSIONS: The ORR, PFS, and OS with anti-PD-1 therapy were poor in patients with AM and MM compared to those previously reported clinical trials for nonacral CM. High serum LDH was associated with significantly shorter OS.
Authors: Paul Nathan; Paolo A Ascierto; John Haanen; Enrique Espinosa; Lev Demidov; Claus Garbe; Michele Guida; Paul Lorigan; Vanna Chiarion-Sileni; Helen Gogas; Michele Maio; Maria Teresa Fierro; Christoph Hoeller; Patrick Terheyden; Ralf Gutzmer; Tormod K Guren; Dimitrios Bafaloukos; Piotr Rutkowski; Ruth Plummer; Ashita Waterston; Martin Kaatz; Mario Mandala; Ivan Marquez-Rodas; Eva Muñoz-Couselo; Reinhard Dummer; Elena Grigoryeva; Tina C Young; Dirk Schadendorf Journal: Eur J Cancer Date: 2019-08-21 Impact factor: 9.162
Authors: Colleen C McLaughlin; Xiao-Cheng Wu; Ahmedin Jemal; Howard J Martin; Lisa M Roche; Vivien W Chen Journal: Cancer Date: 2005-03-01 Impact factor: 6.860
Authors: Sandra P D'Angelo; James Larkin; Jeffrey A Sosman; Celeste Lebbé; Benjamin Brady; Bart Neyns; Henrik Schmidt; Jessica C Hassel; F Stephen Hodi; Paul Lorigan; Kerry J Savage; Wilson H Miller; Peter Mohr; Ivan Marquez-Rodas; Julie Charles; Martin Kaatz; Mario Sznol; Jeffrey S Weber; Alexander N Shoushtari; Mary Ruisi; Joel Jiang; Jedd D Wolchok Journal: J Clin Oncol Date: 2016-11-07 Impact factor: 44.544
Authors: E A Eisenhauer; P Therasse; J Bogaerts; L H Schwartz; D Sargent; R Ford; J Dancey; S Arbuck; S Gwyther; M Mooney; L Rubinstein; L Shankar; L Dodd; R Kaplan; D Lacombe; J Verweij Journal: Eur J Cancer Date: 2009-01 Impact factor: 9.162
Authors: Deborah Kuk; Alexander N Shoushtari; Christopher A Barker; Katherine S Panageas; Rodrigo R Munhoz; Parisa Momtaz; Charlotte E Ariyan; Mary Sue Brady; Daniel G Coit; Kita Bogatch; Margaret K Callahan; Jedd D Wolchok; Richard D Carvajal; Michael A Postow Journal: Oncologist Date: 2016-06-10