Influence of melanoma type on incidence and downstream implications of cutaneous immune-related adverse events in the setting of immune checkpoint inhibitor therapy - 01/06/23
Abstract |
Background |
Emerging evidence suggests that cutaneous immune-related adverse events (cirAEs) are associated with a survival benefit in the setting of advanced melanoma treated with immune checkpoint inhibitor (ICI) therapy. Previous studies have not examined the role of melanoma subtypes on cirAE development and downstream therapeutic outcomes.
Objective |
Examine the impact of melanoma subtypes on cirAE onset and survival among ICI recipients.
Methods |
Retrospective multi-institutional cohort study. Multivariate time-series regressions were utilized to assess relationships between melanoma subtype, cirAE development, and survival.
Results |
Among 747 ICI recipients, 236 (31.6%) patients developed a cirAE. Patients with acral melanoma were less likely to develop a cirAE (hazard ratio [HR] = 0.41, P = .016) compared to patients with nonacral cutaneous melanoma. Across all melanoma subtypes, cirAEs were associated with reduced mortality (HR = 0.76, P = .042). Patients with acral (HR = 2.04, P = .005), mucosal (HR = 2.30, P < .001), and uveal (HR = 4.09, P < .001) primaries exhibited the worst survival.
Limitations |
Retrospective cohort study.
Conclusion |
This is the first study to demonstrate differences in cirAE development among melanoma subtypes. The presence of cirAEs was associated with better survival. Further, the lower incidence of cirAEs may be a marker of immunotherapy response, which is reflected in the association between acral melanoma and mortality.
Le texte complet de cet article est disponible en PDF.Key words : cutaneous immune-related adverse events, immune checkpoint inhibitor, immunotherapy, rare melanoma, skin toxicity
Abbreviation used : AJCC, AM, CCI, CirAEs, CTLA-4, HR, ICD-10, ICI, MM, NACM, NOS, PD-1, PD-L1, UPM, UV
Plan
Drs Nguyen and Wan are co-first authors. |
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Drs Kwatra and Semenov are co-senior authors. |
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Funding sources: YRS is in part supported by the Department of Defense under Award Number W81XWH2110819 and by the Dermatology Foundation under the Medical Dermatology Career Development Award. KHY is in part supported by R35GM142879 from the National Institute of General Medical Sciences, NIH. SGK is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Number K23AR077073. NRL is supported by NIH/NCI grant U54-CA225088. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. |
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IRB approval status: Reviewed and exempted by Mass General Brigham IRB. |
Vol 88 - N° 6
P. 1308-1316 - juin 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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