The Effectiveness of Adjuvant PD-1 Inhibitors in Patients With Surgically Resected Stage III/IV Acral Melanoma

Author:

Arak Haci1,Erkiliç Suna2,Yaslikaya Şendağ3,Eylemer Mocan Eda4,Aktaş Gökmen5,Özdemir Melek6,Semiz Hüseyin Salih7,kiliçkap Saadettin8,Özalp Faruk Recep7,Sever Özlem Nuray9,Akdağ Goncagül9,Ağaoğlu Ahmet Burak10,Özçelik Melike11,Sari Murat12,Arcagök Murat13,Anik Hicran14,Yayla Şaziye Burçak15,Sever Nadiye12,Açar Fatma Pinar15,Bayrakçi İsmail16,Turhal Serdar17,Ayhan Murat18,Kuş Tülay19,

Affiliation:

1. Department of Medical Oncology, School of Medicine, Gaziantep University, Gaziantep, Turkey

2. Department of Pathology, Gaziantep University, Gaziantep, Turkey

3. Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey

4. Department of Medical Oncology, Ankara University, Ankara, Turkey

5. Department of Medical Oncology, Medicalpoint Hospital, Gaziantep, Turkey

6. Department of Medical Oncology, Pamukkale University of Medicine, Denizli, Turkey

7. Department of Medical Oncology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

8. Department of Medical Oncology, Istinye Univessity, Ankara, Turkey

9. Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

10. Department of Medical Oncology, Medical Faculty, Manisa Celal Bayar University Manisa, Turkey

11. Department of Medical Oncology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

12. Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey

13. Department of Medical Oncology, Dicle University Medical Faculty, Diyarbakir, Turkey

14. Department of Medical Oncology, Dr Abdurahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey

15. Department of Medical Oncology, Faculty of Medicine, Ege University, Izmir, Turkey

16. Department of Medical Oncology, Trakya University Faculty of Medicine, Edirne, Turkey

17. Anadolu Health Center, Department of Medical Oncology. İstanbul, Turkey

18. Department of Medical Oncology, Adiyaman Training and Research Hospital, Adiyaman, Turkey

19. Department of Medical Oncology, Gaziantep University School of Medicine, Gaziantep, Turkey

Abstract

Our aim was to assess the efficacy of adjuvant programmed cell death protein-1 (PD-1) inhibitors and compare the other adjuvant treatments in patients with surgically resected stage III or IV acral melanoma. This study is a multicenter, retrospective analysis. We included 114 patients with stage III or IV acral malignant melanoma who underwent surgery within the past 10 years. We analyzed the effect of adjuvant programmed cell death protein-1 inhibitors on disease-free survival (DFS). The mean follow-up was 40 months, during which 69 (59.5%) patients experienced recurrence. Among the participants, 64 (56.1%) received systemic adjuvant therapy. Specifically, 48.4% received anti–PD-1 therapy, 29.7% received interferon, 14.1% received tezozolomide, and 7.8% received B-Raf proto-oncogene/mitogen-activated protein kinase inhibitors. Patients who received adjuvant therapy had a median DFS of 24 (10.9–37.2) months, whereas those who did not receive adjuvant therapy had a median DFS of 15 (9.8–20.2) months. Multivariate analysis for DFS revealed that the receipt of adjuvant therapy and lymph node metastasis stage were independent significant parameters (P = 0.021, P = 0.018, respectively). No statistically significant difference was observed for DFS between programmed cell death protein-1 inhibitor treatment and other adjuvant treatments. Regarding overall survival (OS), patients who received adjuvant treatment had a median OS of 71 (30.4–111.7) months, whereas those who did not receive adjuvant treatment had a median OS of 38 (16.7–59.3; P = 0.023) months. In addition, there were no significant differences in OS observed between various adjuvant treatment agents (P = 0.122). In our study, we have shown that adjuvant therapy had a positive effect on both DFS and OS in patients with stages III–IV acral melanoma who underwent curative intent surgery. Notably, we found no significant differences between anti–PD-1 therapy and other adjuvant therapies.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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