Three-Year Analysis of Adjuvant Therapy in Postoperative Melanoma including Acral and Mucosal Subtypes

Author:

Muto Yusuke1ORCID,Kambayashi Yumi1,Kato Hiroshi2,Mizuhashi Satoru3,Ito Takamichi4ORCID,Maekawa Takeo5,Ishizuki Shoichiro6,Uchi Hiroshi7,Matsushita Shigeto8ORCID,Yamamoto Yuki9,Yoshino Koji10,Fujisawa Yasuhiro11,Amagai Ryo1,Ohuchi Kentaro1,Hashimoto Akira1,Fukushima Satoshi3,Asano Yoshihide1,Fujimura Taku1ORCID

Affiliation:

1. Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan

2. Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan

3. Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan

4. Department of Dermatology, Graduate School of Medical Science, Kyushu University, Fukuoka 812-8582, Japan

5. Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan

6. Department of Dermatology, Faculty of University of Tsukuba, Tsukuba 305-8575, Japan

7. Department of Dermato-Oncology, NHO Kyushu Cancer Center, Fukuoka 811-1395, Japan

8. Department of Dermato-Oncology/Dermatology, NHO Kagoshima Medical Center, Kagoshima 892-0853, Japan

9. Department of Dermatology, Wakayama Medical University, Wakayama 641-0012, Japan

10. Department of Dermato-Oncology/Dermatology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan

11. Department of Dermatology, Ehime University, Matsuyama 791-0295, Japan

Abstract

Background: Adjuvant therapy has improved the clinical prognosis for postoperative melanoma patients. However, the long-term efficacy of this therapy on the melanoma acral and mucosal subtypes has not been fully evaluated in previous trials. This study assessed the 3-year recurrence-free survival and overall survival of patients with melanoma, including the acral and mucosal subtypes, treated with anti-PD-1 antibody (Ab) or with the combination of the BRAF and MEK inhibitors dabrafenib and trametinib. Methods: We retrospectively analyzed both the 3-year time to relapse (TTR) and overall survival (OS) of 120 patients treated with anti-PD-1 antibody (Ab), or with the combination of dabrafenib and trametinib. Results: The overall median TTR was 18.4 months, with a range of 0.69 to 36 months. The 3-year TTR of the acral and mucosal types was 28.1% and 38.5%, respectively. Baseline tumor thickness (TT) and acral type were associated with the TTR in subgroup analysis. Moreover, we classified 104 acral and non-acral cutaneous patients into the anti-PD-1 Abs or dabrafenib plus trametinib combined therapies cohort in multiple analyses. The acral subtype and TT were detected as important prognostic factors. In the 3-year OS, only tumor ulceration was associated with the OS in both univariate and multiple analyses. There was no significant difference in baseline or treatment-related factors of the mucosal type (p > 0.05). Conclusion: This study suggests that adjuvant therapy is more effective with non-acral cutaneous melanoma than either the acral or mucosal types at the 3-year TTR endpoint.

Publisher

MDPI AG

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