Evaluation of the efficacy of immunotherapy for non-resectable mucosal melanoma.

Evaluation of the efficacy of immunotherapy for non-resectable mucosal melanoma.

Publication date: Jun 07, 2019

Immune checkpoint inhibitors are now standard-of-care treatments for metastatic cutaneous melanoma. However, for rare sub-groups, such as mucosal melanomas, few published data are available, and with no established therapeutic guidelines. Our objective was to assess the response to anti-CTLA4 and anti-PD1 immunotherapy in patients with mucosal melanomas.

We performed a single-center, prospective cohort analysis of patients with non-surgical locally advanced and/or metastatic mucosal melanoma receiving anti-CTLA4 and/or anti-PD1 immunotherapy from 2010 to 2016.

Forty-four patients were enrolled, including 18 (40.9%) with head and neck, 12 (27.3%) with vulvo-vaginal and 14 (31.8%) with ano-rectal primary tumours. Eleven (25%) patients had stage 3 disease, and 11 (25%) had distant metastases. The first-line immunotherapy was ipilimumab in 24 patients and pembrolizumab in 20. The objective response rate (ORR) was 8.2% (one complete response) for ipilimumab and 35% (four complete responses) for pembrolizumab. No significant difference was observed for primary tumour location. The median follow-up was 24 months (range 4-73). The median progression-free survival (PFS) in the first-line ipilimumab and pembrolizumab groups was 3 months [95% confidence interval (CI) 2.5-4.6] and 5 months (95% CI 2.6-33.1), respectively (p = 0.0147).

In the patients with unresectable and/or metastatic mucosal melanoma, we found ORR and PFS rates comparable to those in patients with cutaneous melanoma, with no significant differences in the types of mucosal surfaces involved. Anti-PD1 therapy has a more favorable benefit-risk ratio than ipilimumab and should be used preferentially.

Moya-Plana, A., Herrera G’omez, R.G., Rossoni, C., Dercle, L., Ammari, S., , Girault, Roy, S., Scoazec, J.Y., Vagner, S., Janot, F., Eggermont, A.M.M., and Robert, C. Evaluation of the efficacy of immunotherapy for non-resectable mucosal melanoma. 22916. 2019 Cancer Immunol Immunother.

Concepts Keywords
Cohort Mucosal melanoma
Confidence Interval Pembrolizumab
CTLA4 Checkpoint inhibitor
Immunotherapy Ipilimumab
Ipilimumab Immune system
Melanoma Cancer treatments
Melanomas Bristol-Myers Squibb
Metastases Antineoplastic drugs
Metastatic Melanoma
Rectal Organ systems
Tumour Medicine
Immunotherapy
Clinical medicine
Tumour
Metastatic mucosal melanoma
Stage disease
Metastases

Semantics

Type Source Name
gene UNIPROT SPATA2
gene UNIPROT CTLA4
disease MESH melanomas
disease DOID cutaneous melanoma
disease DOID mucosal melanoma
gene UNIPROT SNCA
drug DRUGBANK Pembrolizumab
drug DRUGBANK Ipilimumab
disease MESH metastases
gene UNIPROT PDCD1

Original Article

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