Outcomes of patients with resected stage III/IV acral or mucosal melanoma, treated with adjuvant anti-PD-1 based therapy

Sarah K. Jacques; Janet McKeown; Piyush Grover; Douglas B. Johnson; Anne Zaremba; Florentia Dimitriou; Roi Weiser; Mohamad Farid; Kenjiro Namikawa; Ryan J. Sullivan; Piotr Rutkowski; Celeste Lebbe; Omid Hamid; Jonathan S. Zager; Olivier Michielin; Bart Neyns; Yasuhiro Nakamura; Caroline Robert; Janice Mehnert; Paolo A. Ascierto; Prachi Bhave; Benjamin Park; Lisa Zimmer; Joanna Mangana; Megan Mooradian; Joanna Placzke; Clare Allayous; Isabella C. Glitza Oliva; Inderjit Mehmi; Danielle Depalo; Alexandre Wicky; Julia K. Schwarze; Severine Roy; Christina Boatwright; Vito Vanella; Georgina V. Long; Alexander M. Menzies; Serigne N. Lo; Matteo S. Carlino

doi:10.1016/j.ejca.2024.113563

Outcomes of patients with resected stage III/IV acral or mucosal melanoma, treated with adjuvant anti-PD-1 based therapy

Sarah K. Jacques, Janet McKeown, Piyush Grover, Douglas B. Johnson, Anne Zaremba, Florentia Dimitriou, Roi Weiser, Mohamad Farid, Kenjiro Namikawa, Ryan J. Sullivan, Piotr Rutkowski, Celeste Lebbe, Omid Hamid, Jonathan S. Zager, Olivier Michielin, Bart Neyns, Yasuhiro Nakamura, Caroline Robert, Janice Mehnert, Paolo A. AsciertoPrachi Bhave, Benjamin Park, Lisa Zimmer, Joanna Mangana, Megan Mooradian, Joanna Placzke, Clare Allayous, Isabella C. Glitza Oliva, Inderjit Mehmi, Danielle Depalo, Alexandre Wicky, Julia K. Schwarze, Severine Roy, Christina Boatwright, Vito Vanella, Georgina V. Long, Alexander M. Menzies, Serigne N. Lo, Matteo S. Carlino

Research output: Contribution to journal › Article › peer-review

Abstract

Importance: Acral (AM) and mucosal melanomas (MM) are rare subtypes with a poor prognosis. In those with advanced disease, anti-PD-1 (PD1) therapy has reduced activity compared to that seen in non-acral cutaneous melanoma. Objective: To determine the efficacy of adjuvant PD1 in resected AM or MM. Design: An international, retrospective cohort study Setting: Data up to November 2021 collected from 20 centres across 10 countries. Participants: One hundred and ninety four patients with resected stage III or IV¹ AM or MM who received adjuvant PD1 were included and compared to matched patients from the Melanoma Institute Australia (MIA) database using a propensity score matching analysis. Main outcomes and measures: Recurrence-free survival (RFS), distant metastasis-free survival (DMFS) and overall survival (OS) were investigated. Results: Forty five of 139 (32%) AM and 9 of 55 (16%) MM patients completed adjuvant therapy. The main reason for early treatment cessation in both groups was disease recurrence: 51 (37%) and 30 (55%) in the AM and MM groups, respectively. In the AM group adjuvant PD1 was associated with a longer RFS [HR-0.69 (0.52–0.92, p = 0.0127)], DMFS [HR0.58 (0.38–0.89, p = 0.0134)] and OS [HR of 0.59 (0.38–0.92, p-value 0.0196)] when compared to the historical cohort. In the MM group there was no statistical difference in RFS [HR1.36 (0.69–2.68,p-value 0.3799], DMFS or OS. Conclusion and relevance: After adjuvant PD1, both AM and MM have a high risk of recurrence. Our data suggests a benefit to using adjuvant PD1 therapy in resected AM but not in resected MM. Additional studies to investigate the efficacy of adjuvant PD1 for MM are needed.

Original language	English (US)
Article number	113563
Journal	European Journal of Cancer
Volume	199
DOIs	https://doi.org/10.1016/j.ejca.2024.113563
State	Published - Mar 2024

Keywords

Acral melanoma
Adjuvant
Anti-PD1
Immunotherapy
Mucosal melanoma

ASJC Scopus subject areas

Oncology
Cancer Research

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10.1016/j.ejca.2024.113563

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Jacques, S. K., McKeown, J., Grover, P., Johnson, D. B., Zaremba, A., Dimitriou, F., Weiser, R., Farid, M., Namikawa, K., Sullivan, R. J., Rutkowski, P., Lebbe, C., Hamid, O., Zager, J. S., Michielin, O., Neyns, B., Nakamura, Y., Robert, C., Mehnert, J., ... Carlino, M. S. (2024). Outcomes of patients with resected stage III/IV acral or mucosal melanoma, treated with adjuvant anti-PD-1 based therapy. European Journal of Cancer, 199, Article 113563. https://doi.org/10.1016/j.ejca.2024.113563

Jacques, SK, McKeown, J, Grover, P, Johnson, DB, Zaremba, A, Dimitriou, F, Weiser, R, Farid, M, Namikawa, K, Sullivan, RJ, Rutkowski, P, Lebbe, C, Hamid, O, Zager, JS, Michielin, O, Neyns, B, Nakamura, Y, Robert, C, Mehnert, J, Ascierto, PA, Bhave, P, Park, B, Zimmer, L, Mangana, J, Mooradian, M, Placzke, J, Allayous, C, Glitza Oliva, IC, Mehmi, I, Depalo, D, Wicky, A, Schwarze, JK, Roy, S, Boatwright, C, Vanella, V, Long, GV, Menzies, AM, Lo, SN & Carlino, MS 2024, 'Outcomes of patients with resected stage III/IV acral or mucosal melanoma, treated with adjuvant anti-PD-1 based therapy', European Journal of Cancer, vol. 199, 113563. https://doi.org/10.1016/j.ejca.2024.113563

@article{1ef8a50156b64904b946646285f2259b,

title = "Outcomes of patients with resected stage III/IV acral or mucosal melanoma, treated with adjuvant anti-PD-1 based therapy",

abstract = "Importance: Acral (AM) and mucosal melanomas (MM) are rare subtypes with a poor prognosis. In those with advanced disease, anti-PD-1 (PD1) therapy has reduced activity compared to that seen in non-acral cutaneous melanoma. Objective: To determine the efficacy of adjuvant PD1 in resected AM or MM. Design: An international, retrospective cohort study Setting: Data up to November 2021 collected from 20 centres across 10 countries. Participants: One hundred and ninety four patients with resected stage III or IV1 AM or MM who received adjuvant PD1 were included and compared to matched patients from the Melanoma Institute Australia (MIA) database using a propensity score matching analysis. Main outcomes and measures: Recurrence-free survival (RFS), distant metastasis-free survival (DMFS) and overall survival (OS) were investigated. Results: Forty five of 139 (32%) AM and 9 of 55 (16%) MM patients completed adjuvant therapy. The main reason for early treatment cessation in both groups was disease recurrence: 51 (37%) and 30 (55%) in the AM and MM groups, respectively. In the AM group adjuvant PD1 was associated with a longer RFS [HR-0.69 (0.52–0.92, p = 0.0127)], DMFS [HR0.58 (0.38–0.89, p = 0.0134)] and OS [HR of 0.59 (0.38–0.92, p-value 0.0196)] when compared to the historical cohort. In the MM group there was no statistical difference in RFS [HR1.36 (0.69–2.68,p-value 0.3799], DMFS or OS. Conclusion and relevance: After adjuvant PD1, both AM and MM have a high risk of recurrence. Our data suggests a benefit to using adjuvant PD1 therapy in resected AM but not in resected MM. Additional studies to investigate the efficacy of adjuvant PD1 for MM are needed.",

keywords = "Acral melanoma, Adjuvant, Anti-PD1, Immunotherapy, Mucosal melanoma",

author = "Jacques, {Sarah K.} and Janet McKeown and Piyush Grover and Johnson, {Douglas B.} and Anne Zaremba and Florentia Dimitriou and Roi Weiser and Mohamad Farid and Kenjiro Namikawa and Sullivan, {Ryan J.} and Piotr Rutkowski and Celeste Lebbe and Omid Hamid and Zager, {Jonathan S.} and Olivier Michielin and Bart Neyns and Yasuhiro Nakamura and Caroline Robert and Janice Mehnert and Ascierto, {Paolo A.} and Prachi Bhave and Benjamin Park and Lisa Zimmer and Joanna Mangana and Megan Mooradian and Joanna Placzke and Clare Allayous and {Glitza Oliva}, {Isabella C.} and Inderjit Mehmi and Danielle Depalo and Alexandre Wicky and Schwarze, {Julia K.} and Severine Roy and Christina Boatwright and Vito Vanella and Long, {Georgina V.} and Menzies, {Alexander M.} and Lo, {Serigne N.} and Carlino, {Matteo S.}",

note = "Publisher Copyright: {\textcopyright} 2024",

year = "2024",

month = mar,

doi = "10.1016/j.ejca.2024.113563",

language = "English (US)",

volume = "199",

journal = "European Journal of Cancer",

issn = "0959-8049",

publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Outcomes of patients with resected stage III/IV acral or mucosal melanoma, treated with adjuvant anti-PD-1 based therapy

AU - Jacques, Sarah K.

AU - McKeown, Janet

AU - Grover, Piyush

AU - Johnson, Douglas B.

AU - Zaremba, Anne

AU - Dimitriou, Florentia

AU - Weiser, Roi

AU - Farid, Mohamad

AU - Namikawa, Kenjiro

AU - Sullivan, Ryan J.

AU - Rutkowski, Piotr

AU - Lebbe, Celeste

AU - Hamid, Omid

AU - Zager, Jonathan S.

AU - Michielin, Olivier

AU - Neyns, Bart

AU - Nakamura, Yasuhiro

AU - Robert, Caroline

AU - Mehnert, Janice

AU - Ascierto, Paolo A.

AU - Bhave, Prachi

AU - Park, Benjamin

AU - Zimmer, Lisa

AU - Mangana, Joanna

AU - Mooradian, Megan

AU - Placzke, Joanna

AU - Allayous, Clare

AU - Glitza Oliva, Isabella C.

AU - Mehmi, Inderjit

AU - Depalo, Danielle

AU - Wicky, Alexandre

AU - Schwarze, Julia K.

AU - Roy, Severine

AU - Boatwright, Christina

AU - Vanella, Vito

AU - Long, Georgina V.

AU - Menzies, Alexander M.

AU - Lo, Serigne N.

AU - Carlino, Matteo S.

PY - 2024/3

Y1 - 2024/3

N2 - Importance: Acral (AM) and mucosal melanomas (MM) are rare subtypes with a poor prognosis. In those with advanced disease, anti-PD-1 (PD1) therapy has reduced activity compared to that seen in non-acral cutaneous melanoma. Objective: To determine the efficacy of adjuvant PD1 in resected AM or MM. Design: An international, retrospective cohort study Setting: Data up to November 2021 collected from 20 centres across 10 countries. Participants: One hundred and ninety four patients with resected stage III or IV1 AM or MM who received adjuvant PD1 were included and compared to matched patients from the Melanoma Institute Australia (MIA) database using a propensity score matching analysis. Main outcomes and measures: Recurrence-free survival (RFS), distant metastasis-free survival (DMFS) and overall survival (OS) were investigated. Results: Forty five of 139 (32%) AM and 9 of 55 (16%) MM patients completed adjuvant therapy. The main reason for early treatment cessation in both groups was disease recurrence: 51 (37%) and 30 (55%) in the AM and MM groups, respectively. In the AM group adjuvant PD1 was associated with a longer RFS [HR-0.69 (0.52–0.92, p = 0.0127)], DMFS [HR0.58 (0.38–0.89, p = 0.0134)] and OS [HR of 0.59 (0.38–0.92, p-value 0.0196)] when compared to the historical cohort. In the MM group there was no statistical difference in RFS [HR1.36 (0.69–2.68,p-value 0.3799], DMFS or OS. Conclusion and relevance: After adjuvant PD1, both AM and MM have a high risk of recurrence. Our data suggests a benefit to using adjuvant PD1 therapy in resected AM but not in resected MM. Additional studies to investigate the efficacy of adjuvant PD1 for MM are needed.

AB - Importance: Acral (AM) and mucosal melanomas (MM) are rare subtypes with a poor prognosis. In those with advanced disease, anti-PD-1 (PD1) therapy has reduced activity compared to that seen in non-acral cutaneous melanoma. Objective: To determine the efficacy of adjuvant PD1 in resected AM or MM. Design: An international, retrospective cohort study Setting: Data up to November 2021 collected from 20 centres across 10 countries. Participants: One hundred and ninety four patients with resected stage III or IV1 AM or MM who received adjuvant PD1 were included and compared to matched patients from the Melanoma Institute Australia (MIA) database using a propensity score matching analysis. Main outcomes and measures: Recurrence-free survival (RFS), distant metastasis-free survival (DMFS) and overall survival (OS) were investigated. Results: Forty five of 139 (32%) AM and 9 of 55 (16%) MM patients completed adjuvant therapy. The main reason for early treatment cessation in both groups was disease recurrence: 51 (37%) and 30 (55%) in the AM and MM groups, respectively. In the AM group adjuvant PD1 was associated with a longer RFS [HR-0.69 (0.52–0.92, p = 0.0127)], DMFS [HR0.58 (0.38–0.89, p = 0.0134)] and OS [HR of 0.59 (0.38–0.92, p-value 0.0196)] when compared to the historical cohort. In the MM group there was no statistical difference in RFS [HR1.36 (0.69–2.68,p-value 0.3799], DMFS or OS. Conclusion and relevance: After adjuvant PD1, both AM and MM have a high risk of recurrence. Our data suggests a benefit to using adjuvant PD1 therapy in resected AM but not in resected MM. Additional studies to investigate the efficacy of adjuvant PD1 for MM are needed.

KW - Acral melanoma

KW - Adjuvant

KW - Anti-PD1

KW - Immunotherapy

KW - Mucosal melanoma

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U2 - 10.1016/j.ejca.2024.113563

DO - 10.1016/j.ejca.2024.113563

M3 - Article

C2 - 38278007

AN - SCOPUS:85183487463

SN - 0959-8049

VL - 199

JO - European Journal of Cancer

JF - European Journal of Cancer

M1 - 113563

ER -

Outcomes of patients with resected stage III/IV acral or mucosal melanoma, treated with adjuvant anti-PD-1 based therapy

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ASJC Scopus subject areas

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