S'abonner

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

Doi : 10.1016/j.jaad.2023.02.014 
Nga Nguyen, MD, MPH a, Guihong Wan, PhD a, b, Pearl Ugwu-Dike, BA a, Nora A. Alexander, BS a, Neel Raval, BA a, Shijia Zhang, BA a, b, Ruple Jairath, BS a, Jordan Phillipps, BS a, Bonnie Leung, BS a, c, Katie Roster, MS a, Jayhyun Seo, BA a, Chenyue Lu, MBI a, b, Kimberly Tang, BA a, Min Seok Choi, MS a, Mia S. DeSimone, MD, MPH d, Nicholas Theodosakis, MD, PhD a, Munachimso Amadife, BS a, Nevada Cox, MS a, Thomas K. Le, BS e, Feng Liu, PhD f, Wenxin Chen, MS a, b, Xue Bai, MD g, Genevieve Boland, MD, PhD h, David Liu, MD g, Marc S. Hurlbert, PhD i, Nicole LeBoeuf, MD, MPH c, Kerry L. Reynolds, MD j, Kun-Hsing Yu, MD, PhD b, Hensin Tsao, MD, PhD a, Maryam Asgari, MD, MPH a, k, Alexander Gusev, PhD g, Shawn G. Kwatra, MD e, l, Yevgeniy R. Semenov, MD, MA a,
a Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 
b Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts 
c Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts 
d Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts 
e Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland 
f School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, New Jersey 
g Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts 
h Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts 
i Melanoma Research Alliance, Washington, District of Columbia 
j Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, Massachusetts 
k Department of Population Medicine, Harvard Medical School, Boston, Massachusetts 
l Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland 

Correspondence and reprint requests to: Yevgeniy R. Semenov, MD, MA, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 40 Blossom St, Bartlett Hall 6R, Room 626, Boston, MA 02114.Department of DermatologyMassachusetts General HospitalHarvard Medical School40 Blossom St, Bartlett Hall 6R, Room 626BostonMA02114

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.
 Drs Kwatra and Semenov are co-senior authors.
 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.
 IRB approval status: Reviewed and exempted by Mass General Brigham IRB.


© 2023  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 88 - N° 6

P. 1308-1316 - juin 2023 Retour au numéro
Article précédent Article précédent
  • Paroxetine is an effective treatment for refractory erythema of rosacea: Primary results from the Prospective Rosacea Refractory Erythema Randomized Clinical Trial
  • Ben Wang, Yingxue Huang, Yan Tang, Zhixiang Zhao, Wei Shi, Dan Jian, Fangfen Liu, Qiong Gao, Peiru Wang, Jie Yang, Lin Li, Hongfu Xie, Ji Li
| Article suivant Article suivant
  • Dermatopathologic features of cutaneous squamous cell carcinoma and actinic keratosis: Consensus criteria and proposed reporting guidelines
  • Rachel E. Christensen, Dirk M. Elston, Brandon Worley, McKenzie A. Dirr, Noor Anvery, Bianca Y. Kang, Soon Bahrami, Robert T. Brodell, Lorenzo Cerroni, Carly Elston, Tammie Ferringer, M. Yadira Hurley, Kyle Garton, Joyce Siong See Lee, Yeqiang Liu, John C. Maize, Jennifer M. McNiff, Ronald P. Rapini, Omar P. Sangueza, Christopher R. Shea, Cheng Zhou, Murad Alam

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.


Tout le contenu de ce site: Copyright © 2025 Elsevier, ses concédants de licence et ses contributeurs. Tout les droits sont réservés, y compris ceux relatifs à l'exploration de textes et de données, a la formation en IA et aux technologies similaires. Pour tout contenu en libre accès, les conditions de licence Creative Commons s'appliquent.