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

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. To determine the efficacy of adjuvant PD1 in resected AM or MM. An international, retrospective cohort study SETTING: Data up to November 2021 collected from 20 centres across 10 countries. One hundred and ninety four patients with resected stage III or IV Recurrence-free survival (RFS), distant metastasis-free survival (DMFS) and overall survival (OS) were investigated. 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. 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.

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Copyright © 2024. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: MSC: consultant advisor for Amgen, BMS, Eisai, Ideaya, MSD, Nektar, Novartis, Oncosec, Pierre-Fabre, Qbiotics, Regeneron, Roche, Merck and Sanofi, and received honoraria from BMS, MSD, Sanofi and Novartis. DBJ: advisory boards or as a consultant for BMS, Catalyst Biopharma, Iovance, Mallinckrodt, Merck, Mosaic ImmunoEngineering, Novartis, Oncosec, Pfizer, Targovax, and Teiko, and has received research funding from BMS and Incyte. RJS: Advisory boards/consulting for BMS, Merck, Novartis, Marengo, Pfizer, and Replimune and received research funding from Merck. FD: receives/received honoraria and travel support from Pierre Fabre, Merck Sharp & Dohme, Bristol Myers Squibb and Sun Pharma.CL : consultant advisor for BMS, MSD, Novartis, Pierre-Fabre, Merck and Sanofi YN: advisory boards/consulting for MSD and Novartis and received honoraria from Alexion Pharma, BMS, Maruho, MSD, Novartis, Ono Pharma, Sanofi, SunPharma, and Tanabe-Mitsubishi Pharma AMM: consultant advisor for BMS, MSD, Novartis, Roche, Pierre-Fabre, QBioticsKN: advisory board for Novartis and MSD, honoraria from Ono pharmaceutical, Novartis, Bristol-Myers Squibb, and MSD.LZ: served as consultant and has received honoraria from BMS, MSD, Novartis, Pierre Fabre, Sanofi, and Sunpharma and travel support from MSD, BMS, Pierre Fabre, Sanofi, Sunpharma and Novartis, outside the submitted work.JS: Honoraria: Novartis; Travel, Accommodations, Expenses: Amgen, Merck Sharp & DohmePB: conference sponsorship BMS, MSD, Novartis; speaker fees: Novartis, MSD.JP: Received travel support from Pierre Fabre, MSD, BMS, Novartis outside the scope of this study. All remaining authors have declared no conflicts of interest.