TY - JOUR
T1 - Influence of melanoma type on incidence and downstream implications of cutaneous immune-related adverse events in the setting of immune checkpoint inhibitor therapy
AU - Nguyen, Nga
AU - Wan, Guihong
AU - Ugwu-Dike, Pearl
AU - Alexander, Nora A.
AU - Raval, Neel
AU - Zhang, Shijia
AU - Jairath, Ruple
AU - Phillipps, Jordan
AU - Leung, Bonnie
AU - Roster, Katie
AU - Seo, Jayhyun
AU - Lu, Chenyue
AU - Tang, Kimberly
AU - Choi, Min Seok
AU - DeSimone, Mia S.
AU - Theodosakis, Nicholas
AU - Amadife, Munachimso
AU - Cox, Nevada
AU - Le, Thomas K.
AU - Liu, Feng
AU - Chen, Wenxin
AU - Bai, Xue
AU - Boland, Genevieve
AU - Liu, David
AU - Hurlbert, Marc S.
AU - LeBoeuf, Nicole
AU - Reynolds, Kerry L.
AU - Yu, Kun Hsing
AU - Tsao, Hensin
AU - Asgari, Maryam
AU - Gusev, Alexander
AU - Kwatra, Shawn G.
AU - Semenov, Yevgeniy R.
N1 - Publisher Copyright:
© 2023 American Academy of Dermatology, Inc.
PY - 2023/6
Y1 - 2023/6
N2 - Background: Emerging evidence suggests that cutaneous immune-related adverse events (cirAEs) are associated with a survival benefit in the setting of advanced melanoma treated with immune checkpoint inhibitor (ICI) therapy. Previous studies have not examined the role of melanoma subtypes on cirAE development and downstream therapeutic outcomes. Objective: Examine the impact of melanoma subtypes on cirAE onset and survival among ICI recipients. Methods: Retrospective multi-institutional cohort study. Multivariate time-series regressions were utilized to assess relationships between melanoma subtype, cirAE development, and survival. Results: Among 747 ICI recipients, 236 (31.6%) patients developed a cirAE. Patients with acral melanoma were less likely to develop a cirAE (hazard ratio [HR] = 0.41, P =.016) compared to patients with nonacral cutaneous melanoma. Across all melanoma subtypes, cirAEs were associated with reduced mortality (HR = 0.76, P =.042). Patients with acral (HR = 2.04, P =.005), mucosal (HR = 2.30, P <.001), and uveal (HR = 4.09, P <.001) primaries exhibited the worst survival. Limitations: Retrospective cohort study. Conclusion: This is the first study to demonstrate differences in cirAE development among melanoma subtypes. The presence of cirAEs was associated with better survival. Further, the lower incidence of cirAEs may be a marker of immunotherapy response, which is reflected in the association between acral melanoma and mortality.
AB - Background: Emerging evidence suggests that cutaneous immune-related adverse events (cirAEs) are associated with a survival benefit in the setting of advanced melanoma treated with immune checkpoint inhibitor (ICI) therapy. Previous studies have not examined the role of melanoma subtypes on cirAE development and downstream therapeutic outcomes. Objective: Examine the impact of melanoma subtypes on cirAE onset and survival among ICI recipients. Methods: Retrospective multi-institutional cohort study. Multivariate time-series regressions were utilized to assess relationships between melanoma subtype, cirAE development, and survival. Results: Among 747 ICI recipients, 236 (31.6%) patients developed a cirAE. Patients with acral melanoma were less likely to develop a cirAE (hazard ratio [HR] = 0.41, P =.016) compared to patients with nonacral cutaneous melanoma. Across all melanoma subtypes, cirAEs were associated with reduced mortality (HR = 0.76, P =.042). Patients with acral (HR = 2.04, P =.005), mucosal (HR = 2.30, P <.001), and uveal (HR = 4.09, P <.001) primaries exhibited the worst survival. Limitations: Retrospective cohort study. Conclusion: This is the first study to demonstrate differences in cirAE development among melanoma subtypes. The presence of cirAEs was associated with better survival. Further, the lower incidence of cirAEs may be a marker of immunotherapy response, which is reflected in the association between acral melanoma and mortality.
KW - cutaneous immune-related adverse events
KW - immune checkpoint inhibitor
KW - immunotherapy
KW - rare melanoma
KW - skin toxicity
UR - http://www.scopus.com/inward/record.url?scp=85153797658&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85153797658&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2023.02.014
DO - 10.1016/j.jaad.2023.02.014
M3 - Article
C2 - 36828138
AN - SCOPUS:85153797658
SN - 0190-9622
VL - 88
SP - 1308
EP - 1316
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 6
ER -