Survival and prognosis of individuals receiving programmed cell death 1 inhibitor with and without immunologic cutaneous adverse events.
Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Immunological
/ pharmacology
Australia
/ epidemiology
Eczema
/ chemically induced
Female
Follow-Up Studies
Humans
Hypopigmentation
/ chemically induced
Incidence
Lichenoid Eruptions
/ chemically induced
Male
Melanoma
/ drug therapy
Middle Aged
Prognosis
Programmed Cell Death 1 Receptor
/ antagonists & inhibitors
Progression-Free Survival
Prospective Studies
Skin
/ drug effects
Skin Neoplasms
/ drug therapy
Young Adult
PD-1
dermatitis
lichenoid reaction
melanoma
vitiligo-like depigmentation
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
22
12
2018
revised:
05
05
2019
accepted:
17
06
2019
pubmed:
25
6
2019
medline:
14
8
2020
entrez:
25
6
2019
Statut:
ppublish
Résumé
The treatment response to new immunotherapy in advanced melanoma patients remains varied between individuals. Immune-related cutaneous side effects might have prognostic value. To determine whether development of ≥1 of the 3 immune-mediated cutaneous events (eczema, lichenoid reaction, or vitiligo-like depigmentation) is associated with improved progression-free survival. A cohort study of adults with stage IIIC-IV melanoma treated with pembrolizumab or nivolumab during May 1, 2012-February 1, 2018, at Westmead Hospital, Sydney, Australia. Treatment response was based on iRECIST version 1.1. In total, 82 patients of an average age of 59.9 years were included. Median follow-up was 40.7 months; 33 patients had ≥1 target skin reaction. Skin reactions developed in one-third of individuals by 6 months. At any given time, the instantaneous risk of disease progression and death was lower for individuals who had ≥1 cutaneous adverse event (CAE) develop. Compared with individuals with no CAE, the hazard ratio for disease progression and death for individuals who had ≥1 CAE develop was 0.46 (95% confidence interval 0.23-0.91; P = .025) by the time-dependent Cox proportional hazards model. Single-center study. This study demonstrates an association between the development of ≥1 of 3 CAEs and improved progression-free survival in this cohort of patients.
Sections du résumé
BACKGROUND
BACKGROUND
The treatment response to new immunotherapy in advanced melanoma patients remains varied between individuals. Immune-related cutaneous side effects might have prognostic value.
OBJECTIVE
OBJECTIVE
To determine whether development of ≥1 of the 3 immune-mediated cutaneous events (eczema, lichenoid reaction, or vitiligo-like depigmentation) is associated with improved progression-free survival.
METHODS
METHODS
A cohort study of adults with stage IIIC-IV melanoma treated with pembrolizumab or nivolumab during May 1, 2012-February 1, 2018, at Westmead Hospital, Sydney, Australia. Treatment response was based on iRECIST version 1.1.
RESULTS
RESULTS
In total, 82 patients of an average age of 59.9 years were included. Median follow-up was 40.7 months; 33 patients had ≥1 target skin reaction. Skin reactions developed in one-third of individuals by 6 months. At any given time, the instantaneous risk of disease progression and death was lower for individuals who had ≥1 cutaneous adverse event (CAE) develop. Compared with individuals with no CAE, the hazard ratio for disease progression and death for individuals who had ≥1 CAE develop was 0.46 (95% confidence interval 0.23-0.91; P = .025) by the time-dependent Cox proportional hazards model.
LIMITATIONS
CONCLUSIONS
Single-center study.
CONCLUSION
CONCLUSIONS
This study demonstrates an association between the development of ≥1 of 3 CAEs and improved progression-free survival in this cohort of patients.
Identifiants
pubmed: 31233857
pii: S0190-9622(19)31024-2
doi: 10.1016/j.jaad.2019.06.035
pii:
doi:
Substances chimiques
Antineoplastic Agents, Immunological
0
PDCD1 protein, human
0
Programmed Cell Death 1 Receptor
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
311-316Informations de copyright
Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.