Melanoma Research

<jats:p>Patients with mucosal melanoma have lower survival rates than those with cutaneous melanoma. Recent studies have reported lower mucosal melanoma survival rates with the use of immune checkpoint inhibitors (ICIs). This study analyzed ICI treatment outcomes in patients with mucosal melanoma in a real-world context. The objective response rate, progression-free survival (PFS), and overall survival (OS) after first- and second-line ICI treatments were analyzed in a population of patients with advanced mucosal melanoma included in the observational GEM1801 study in Spain. Univariate Cox regression analysis was used to identify prognostic factors. From 1126 patients included between August 2018 and January 2024, 52 (4.6%) patients with mucosal melanoma were selected, with a median age at advanced stage diagnosis of 70 years; 50% were female. Most patients had an Eastern Cooperative Oncology Group performance status of 0 (48%). Tumors were primarily located in the lower gastrointestinal tract (40%) and the nasal cavity (35%). In the metastatic setting, 32 (62%) patients received ICI. At a median follow-up of 13.7 months, patients receiving ICI had a median PFS and OS of 9.4 [95% confidence interval (CI): 6.6–17.0] and 25.9 (95% CI: 21–not reached) months, respectively, for first-line treatment, and 5.1 (95% CI: 1.9–not reached) and 21.0 (95% CI: 11.1–not reached) months for second-line treatment. The clinical benefit of ICI treatment in mucosal melanoma is in accordance with previous clinical trials but is still limited, highlighting the need for new approaches for this patient population.</jats:p>

publication_history

received

accepted

The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society.

Cancer

Primary mucosal melanomas: a comprehensive review.

Int J Clin Exp Pathol

Somatic activation of KIT in distinct subtypes of melanoma.

J Clin Oncol

Whole-genome landscapes of major melanoma subtypes.

Nature

Mucosal melanoma staging and classification: firstly established.

An evidence-based staging system for mucosal melanoma: a proposal.

Ann Surg Oncol

Final, 10-year outcomes with nivolumab plus ipilimumab in advanced melanoma.

N Engl J Med

Single-agent anti-PD-1 or combined with ipilimumab in patients with mucosal melanoma: an international, retrospective, cohort study.

Ann Oncol

Anti-PD-1 antibody monotherapy versus anti-PD-1 plus anti-CTLA-4 combination therapy as first-line immunotherapy in unresectable or metastatic mucosal melanoma: a retrospective, multicenter study of 329 Japanese cases (JMAC study).

ESMO Open

First-line, fixed-duration nivolumab plus ipilimumab followed by nivolumab in clinically diverse patient populations with unresectable stage III or IV melanoma: checkmate 401.

Epidemiology and molecular profile of mucosal melanoma: a population-based study in southern Europe.

Cancers

Efficacy and safety of nivolumab alone or in combination with ipilimumab in patients with mucosal melanoma: a pooled analysis.

Combined nivolumab and ipilimumab or monotherapy in untreated melanoma.

Antitumour activity of pembrolizumab in advanced mucosal melanoma: a post-hoc analysis of KEYNOTE-001, 002, 006.

Br J Cancer

Multicenter prospective phase II trial of nivolumab in patients with unresectable or metastatic mucosal melanoma.

Int J Clin Oncol

Relatlimab and nivolumab versus nivolumab in untreated advanced melanoma.

Atezolizumab plus bevacizumab versus sunitinib in patients with previously untreated metastatic renal cell carcinoma (IMmotion151): a multicentre, open-label, phase 3, randomised controlled trial.

Lancet

Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma.

Atezolizumab plus bevacizumab and chemotherapy for metastatic, persistent, or recurrent cervical cancer (BEATcc): a randomised, open-label, phase 3 trial.

Phase III, randomized study of atezolizumab plus bevacizumab and chemotherapy in patients with EGFR- or ALK-mutated non-small-cell lung cancer (ATTLAS, KCSG-LU19-04).

Atezolizumab plus bevacizumab in patients with unresectable or metastatic mucosal melanoma: a multicenter, open-label, single-arm phase II study.

Clin Cancer Res

Single-arm study of camrelizumab plus apatinib for patients with advanced mucosal melanoma.

J ImmunoTher Cancer

Axitinib in combination with toripalimab, a humanized immunoglobulin G4 monoclonal antibody against programmed cell death-1, in patients with metastatic mucosal melanoma: an open-label phase IB trial.

Toripalimab plus axitinib in patients with metastatic mucosal melanoma: 3-year survival update and biomarker analysis.

1174P sex differences in advanced melanoma in Spain: results from the prospective real-world study GEM 1801.

Sex-based differences in treatment with immune checkpoint inhibition and targeted therapy for advanced melanoma: a nationwide cohort study.

Sex-based differences in melanoma survival in a contemporary patient cohort.

J Womens Health (Larchmt)

Sex-based dimorphism of anticancer immune response and molecular mechanisms of immune evasion.

Impact of initial stage on metastatic melanoma survival.

Melanoma Res

Patients with mucosal melanoma have lower survival rates than those with cutaneous melanoma. Recent studies have reported lower mucosal melanoma survival rates with the use of immune checkpoint inhibitors (ICIs). This study analyzed ICI treatment outcomes in patients with mucosal melanoma in a real-world context. The objective response rate, progression-free survival (PFS), and overall survival (OS) after first- and second-line ICI treatments were analyzed in a population of patients with advanced mucosal melanoma included in the observational GEM1801 study in Spain. Univariate Cox regression analysis was used to identify prognostic factors. From 1126 patients included between August 2018 and January 2024, 52 (4.6%) patients with mucosal melanoma were selected, with a median age at advanced stage diagnosis of 70 years; 50% were female. Most patients had an Eastern Cooperative Oncology Group performance status of 0 (48%). Tumors were primarily located in the lower gastrointestinal tract (40%) and the nasal cavity (35%). In the metastatic setting, 32 (62%) patients received ICI. At a median follow-up of 13.7 months, patients receiving ICI had a median PFS and OS of 9.4 [95% confidence interval (CI): 6.6-17.0] and 25.9 (95% CI: 21-not reached) months, respectively, for first-line treatment, and 5.1 (95% CI: 1.9-not reached) and 21.0 (95% CI: 11.1-not reached) months for second-line treatment. The clinical benefit of ICI treatment in mucosal melanoma is in accordance with previous clinical trials but is still limited, highlighting the need for new approaches for this patient population.

Treatment outcomes in patients with advanced mucosal melanoma in Spain: results from the real-world GEM1801 study.

Treatment outcomes in patients with advanced mucosal melanoma in Spain: results from the real-world GEM1801 study

Treatment outcomes in patients with advanced mucosal melanoma in Spain: results from the real-world GEM1801 study

Clinical Summary

What was studied

Key findings

Study limitations

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