Analysis of tumor response and clinical factors associated with vitiligo in patients receiving anti–programmed cell death-1 therapies for melanoma: A cross-sectional studyCapsule Summary

Léa Dousset, MD; Alize Pacaud, MD; Thomas Barnetche, PhD; Marie Kostine, MD, PhD; Caroline Dutriaux, MD; Anne Pham-Ledard, MD, PhD; Marie Beylot-Barry, MD, PhD; Emilie Gérard, MD; Sorilla Prey, MD, PhD; Nicolas Andreu, BSc; Katia Boniface, PhD; Julien Seneschal, MD, PhD

JAAD International (Dec 2021)

Analysis of tumor response and clinical factors associated with vitiligo in patients receiving anti–programmed cell death-1 therapies for melanoma: A cross-sectional studyCapsule Summary

Léa Dousset, MD,
Alize Pacaud, MD,
Thomas Barnetche, PhD,
Marie Kostine, MD, PhD,
Caroline Dutriaux, MD,
Anne Pham-Ledard, MD, PhD,
Marie Beylot-Barry, MD, PhD,
Emilie Gérard, MD,
Sorilla Prey, MD, PhD,
Nicolas Andreu, BSc,
Katia Boniface, PhD,
Julien Seneschal, MD, PhD

Affiliations

Léa Dousset, MD: Department of Dermatology, National Centre for Rare Skin Disorders, University Hospital of Bordeaux, Bordeaux, France
Alize Pacaud, MD: Department of Dermatology, National Centre for Rare Skin Disorders, University Hospital of Bordeaux, Bordeaux, France
Thomas Barnetche, PhD: Department of Rheumatology, National Reference Center for Severe Systemic Autoimmune Diseases, FHU ACRONIM, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France
Marie Kostine, MD, PhD: Department of Rheumatology, National Reference Center for Severe Systemic Autoimmune Diseases, FHU ACRONIM, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France
Caroline Dutriaux, MD: Department of Dermatology, National Centre for Rare Skin Disorders, University Hospital of Bordeaux, Bordeaux, France; U1035 INSERM, Biotherapy of Genetic Diseases, Inflammatory Disorders and Cancers, Bordeaux University, Bordeaux, France
Anne Pham-Ledard, MD, PhD: Department of Dermatology, National Centre for Rare Skin Disorders, University Hospital of Bordeaux, Bordeaux, France
Marie Beylot-Barry, MD, PhD: Department of Dermatology, National Centre for Rare Skin Disorders, University Hospital of Bordeaux, Bordeaux, France
Emilie Gérard, MD: Department of Dermatology, National Centre for Rare Skin Disorders, University Hospital of Bordeaux, Bordeaux, France
Sorilla Prey, MD, PhD: Department of Dermatology, National Centre for Rare Skin Disorders, University Hospital of Bordeaux, Bordeaux, France; U1035 INSERM, Biotherapy of Genetic Diseases, Inflammatory Disorders and Cancers, Bordeaux University, Bordeaux, France
Nicolas Andreu, BSc: Department of Dermatology, National Centre for Rare Skin Disorders, University Hospital of Bordeaux, Bordeaux, France
Katia Boniface, PhD: U1035 INSERM, Biotherapy of Genetic Diseases, Inflammatory Disorders and Cancers, Bordeaux University, Bordeaux, France
Julien Seneschal, MD, PhD: Department of Dermatology, National Centre for Rare Skin Disorders, University Hospital of Bordeaux, Bordeaux, France; U1035 INSERM, Biotherapy of Genetic Diseases, Inflammatory Disorders and Cancers, Bordeaux University, Bordeaux, France; Correspondence to: Julien Seneschal, MD, PhD, Department of Dermatology, University Hospital of Bordeaux, Saint-André Hospital, 1 rue Jean Burguet, Bordeaux 33075, France.

Journal volume & issue: Vol. 5
pp. 112 – 120

Abstract

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Background: Clinical factors associated with vitiligo in patients receiving anti–programmed cell death-1 (PD-1) remain unknown. Objective: To better characterize the occurrence of vitiligo in patients receiving anti–PD-1. Methods: The present single-center ambispective cohort study included patients with melanoma treated with anti–PD-1. Progression-free survival, overall survival, and objective tumor response were compared between patients with and those without vitiligo using Kaplan-Meier curves and the log-rank test. Demographic and clinical factors associated with vitiligo were evaluated using multivariate logistic regression. Results: Of the 457 patients included in the study, vitiligo developed in 85 patients. The clinical presentation of vitiligo consisted of the presence of ovalar and multiple flecked white macules, mainly located on chronic sun-exposed areas. The presence of vitiligo was associated with a significant improvement in overall survival and progression-free survival (P < .001). A Cox proportional hazards model estimation demonstrated markedly improved survival in patients with vitiligo compared with those without vitiligo (aHR [overall survival], 0.20; 95% CI, 0.12-0.33; P < .001; and aHR [progression-free survival], 0.33; 95% CI, 0.23-0.47; P < .001). In the multivariate logistic regression analyses, men showed an independent increased risk of the development of vitiligo (odds ratio, 1.66). In contrast, the presence of pulmonary metastases was found to be an independent factor associated with a reduced risk of the development of vitiligo (odds ratio, 0.50). Limitations: Single-center ambispective cohort. Conclusion: Vitiligo in patients receiving anti–PD-1 for advanced melanoma is associated with a better outcome. A gender effect associated with the development of vitiligo will need further investigation.

Published in JAAD International

ISSN: 2666-3287 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Dermatology
Website: https://www.journals.elsevier.com/jaad-international

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