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Li T, Xu Y, Sun W, Yan W, Wang C, Hu T, Zhang X, Luo Z, Liu X, Chen Y. Adjuvant Anti-PD-1 Immunotherapy versus Conventional Therapy for Stage III Melanoma: A Real-World Retrospective Cohort Study. Pharmaceuticals (Basel) 2022; 16:ph16010041. [PMID: 36678538 PMCID: PMC9867270 DOI: 10.3390/ph16010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022] Open
Abstract
The use of adjuvant therapy has provided survival benefits in patients with advanced melanoma. This study aimed to explore the recurrence and prognosis of the PD-1 inhibitor, conventional interferon (IFN), or observation (OBS) on resected stage III acral and cutaneous melanoma patients through a retrospective analysis. Patients with resected stage III melanoma at Fudan University Shanghai Cancer Center from 2017 to 2021 were enrolled with all of their clinicopathologic characteristics collected. They were divided into three groups: PD-1 inhibitor, IFN, and OBS. Survival analyses were performed to indicate the significance of different adjuvant therapies. A total of 199 patients were enrolled (PD-1 n = 126; IFN n = 31; and OBS n = 42), with their median follow-up times being 21 months, 24 months, and 49 months, respectively. The PD-1 inhibitor significantly improved relapse-free survival (p = 0.027) and overall survival (p = 0.033) compared with conventional treatment (IFN+OBS). The superiority of the PD-1 inhibitor was witnessed in stage IIIC/D (p = 0.000) acral (p = 0.05) melanoma patients with ulceration (p = 0.011) or lymph node macrometastasis (p = 0.010). The PD-1 inhibitor significantly reduced local recurrence and systemic metastasis compared with conventional therapy (p = 0.002). In conclusion, adjuvant anti-PD-1 immunotherapy can achieve better survival outcomes in acral and cutaneous melanoma patients compared with conventional treatment, without considering adverse events. More clinical benefits were seen in later-stage acral melanoma patients with ulceration or lymph node macrometastasis.
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Affiliation(s)
- Tong Li
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
- Shanghai Pancreatic Cancer Institute, Shanghai 200032, China
- Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China
| | - Yu Xu
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Wei Sun
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Wangjun Yan
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Chunmeng Wang
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Tu Hu
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Xiaowei Zhang
- Department of Internal Medicine of Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Department of Gastrointestinal Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Zhiguo Luo
- Department of Internal Medicine of Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Department of Gastrointestinal Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Xin Liu
- Department of Internal Medicine of Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Department of Head and Neck and Neuroendocrine Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yong Chen
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Correspondence:
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Mejbel HA, Torres-Cabala CA, Milton DR, Ivan D, Nagarajan P, Curry JL, Ciurea AM, Rubin AI, Hwu WJ, Prieto VG, Aung PP. Prognostic Significance of Subungual Anatomic Site in Acral Lentiginous Melanoma. Arch Pathol Lab Med 2020; 145:943-952. [PMID: 33290520 DOI: 10.5858/arpa.2020-0308-oa] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Acral lentiginous melanoma is a rare and aggressive type of cutaneous melanoma that arises on the acral skin and the nail unit. The prognostic significance of subungual anatomic site in acral lentiginous melanoma is not established. OBJECTIVE.— To assess the impact of subungual anatomic site on overall survival and disease-specific survival in acral lentiginous melanoma. DESIGN.— Retrospective cohort analysis. Clinicopathologic characteristics of 627 primary acral lentiginous melanomas (45 [7%] subungual and 582 [93%] nonsubungual) were summarized, and the impact of these characteristics on overall survival and disease-specific survival was determined using univariate and multivariable analyses. RESULTS.— No significant differences in clinicopathologic features were identified between the subungual and nonsubungual acral lentiginous melanomas. The 1-, 5-, and 10-year overall survival rates were 81%, 40%, and 28%, respectively, for subungual acral lentiginous melanoma and 94%, 59%, and 38%, respectively, for nonsubungual acral lentiginous melanoma (P = .04); risk of death was significantly higher for subungual tumors (hazard ratio [95% confidence interval] = 1.59 [1.02-2.50]; P = .04). The 1-, 5-, and 10-year disease-specific survival rates were 94%, 56%, and 48%, respectively, for subungual acral lentiginous melanoma versus 96%, 69%, and 55%, respectively, for nonsubungual acral lentiginous melanoma (P = .18). By multivariable analysis, independent poor prognostic factors included older age and ulceration for overall survival and greater Breslow thickness and sentinel lymph node positivity for overall survival and disease-specific survival. Subungual anatomic site was not an independent prognostic factor for overall or disease-specific survival. CONCLUSIONS.— Subungual anatomic site is not an independent prognostic factor for acral lentiginous melanoma.
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Affiliation(s)
- Haider A Mejbel
- From the Department of Pathology (Mejbel, Torres-Cabala, Ivan, Nagarajan, Curry, Prieto, Aung), The University of Texas MD Anderson Cancer Center, Houston
| | - Carlos A Torres-Cabala
- From the Department of Pathology (Mejbel, Torres-Cabala, Ivan, Nagarajan, Curry, Prieto, Aung), The University of Texas MD Anderson Cancer Center, Houston.,Department of Dermatology (Torres-Cabala, Ivan, Curry, Ciurea, Prieto), The University of Texas MD Anderson Cancer Center, Houston
| | - Denái R Milton
- Department of Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Doina Ivan
- From the Department of Pathology (Mejbel, Torres-Cabala, Ivan, Nagarajan, Curry, Prieto, Aung), The University of Texas MD Anderson Cancer Center, Houston.,Department of Dermatology (Torres-Cabala, Ivan, Curry, Ciurea, Prieto), The University of Texas MD Anderson Cancer Center, Houston
| | - Priyadharsini Nagarajan
- From the Department of Pathology (Mejbel, Torres-Cabala, Ivan, Nagarajan, Curry, Prieto, Aung), The University of Texas MD Anderson Cancer Center, Houston
| | - Jonathan L Curry
- From the Department of Pathology (Mejbel, Torres-Cabala, Ivan, Nagarajan, Curry, Prieto, Aung), The University of Texas MD Anderson Cancer Center, Houston.,Department of Dermatology (Torres-Cabala, Ivan, Curry, Ciurea, Prieto), The University of Texas MD Anderson Cancer Center, Houston
| | - Ana M Ciurea
- Department of Dermatology (Torres-Cabala, Ivan, Curry, Ciurea, Prieto), The University of Texas MD Anderson Cancer Center, Houston
| | - Adam I Rubin
- The Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (Rubin)
| | - Wen-Jen Hwu
- Melanoma Medical Oncology (Hwu), The University of Texas MD Anderson Cancer Center, Houston
| | - Victor G Prieto
- From the Department of Pathology (Mejbel, Torres-Cabala, Ivan, Nagarajan, Curry, Prieto, Aung), The University of Texas MD Anderson Cancer Center, Houston.,Department of Dermatology (Torres-Cabala, Ivan, Curry, Ciurea, Prieto), The University of Texas MD Anderson Cancer Center, Houston
| | - Phyu P Aung
- From the Department of Pathology (Mejbel, Torres-Cabala, Ivan, Nagarajan, Curry, Prieto, Aung), The University of Texas MD Anderson Cancer Center, Houston
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