Benefit, recurrence pattern, and toxicity to adjuvant anti-PD-1 monotherapy varies by ethnicity and melanoma subtype: An international multicenter cohort studyCapsule Summary

Xue Bai, MD; Aleigha R. Lawless, BS; Juliane A. Czapla, MS; Stefanie C. Gerstberger, MD, PhD; Benjamin C. Park, MD; Seungyeon Jung, BA; Rebecca Johnson, MN; Naoya Yamazaki, MD, PhD; Dai Ogata, MD, PhD; Yoshiyasu Umeda, MD; Caili Li, MB; Jun Guo, MD, PhD; Keith T. Flaherty, MD; Yasuhiro Nakamura, MD, PhD; Kenjiro Namikawa, MD, PhD; Georgina V. Long, MBBS, PhD; Alexander M. Menzies, MBBS, PhD; Douglas B. Johnson, MD; Ryan J. Sullivan, MD; Genevieve M. Boland, MD, PhD; Lu Si, MD

JAAD International (Jun 2024)

Benefit, recurrence pattern, and toxicity to adjuvant anti-PD-1 monotherapy varies by ethnicity and melanoma subtype: An international multicenter cohort studyCapsule Summary

Xue Bai, MD,
Aleigha R. Lawless, BS,
Juliane A. Czapla, MS,
Stefanie C. Gerstberger, MD, PhD,
Benjamin C. Park, MD,
Seungyeon Jung, BA,
Rebecca Johnson, MN,
Naoya Yamazaki, MD, PhD,
Dai Ogata, MD, PhD,
Yoshiyasu Umeda, MD,
Caili Li, MB,
Jun Guo, MD, PhD,
Keith T. Flaherty, MD,
Yasuhiro Nakamura, MD, PhD,
Kenjiro Namikawa, MD, PhD,
Georgina V. Long, MBBS, PhD,
Alexander M. Menzies, MBBS, PhD,
Douglas B. Johnson, MD,
Ryan J. Sullivan, MD,
Genevieve M. Boland, MD, PhD,
Lu Si, MD

Affiliations

Xue Bai, MD: Department of Melanoma and Sarcoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education, Beijing), Peking University Cancer Hospital and Institute, Beijing, China; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
Aleigha R. Lawless, BS: Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
Juliane A. Czapla, MS: Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
Stefanie C. Gerstberger, MD, PhD: Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
Benjamin C. Park, MD: Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
Seungyeon Jung, BA: Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
Rebecca Johnson, MN: Melanoma Institute Australia, The University of Sydney, Faculty of Medicine and Health, The University of Sydney, and Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, Australia
Naoya Yamazaki, MD, PhD: Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
Dai Ogata, MD, PhD: Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
Yoshiyasu Umeda, MD: Department of Skin Oncology/Dermatology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Caili Li, MB: Department of Melanoma and Sarcoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education, Beijing), Peking University Cancer Hospital and Institute, Beijing, China
Jun Guo, MD, PhD: Department of Melanoma and Sarcoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education, Beijing), Peking University Cancer Hospital and Institute, Beijing, China
Keith T. Flaherty, MD: Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
Yasuhiro Nakamura, MD, PhD: Department of Skin Oncology/Dermatology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Kenjiro Namikawa, MD, PhD: Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
Georgina V. Long, MBBS, PhD: Melanoma Institute Australia, The University of Sydney, Faculty of Medicine and Health, The University of Sydney, and Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, Australia
Alexander M. Menzies, MBBS, PhD: Melanoma Institute Australia, The University of Sydney, Faculty of Medicine and Health, The University of Sydney, and Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, Australia
Douglas B. Johnson, MD: Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
Ryan J. Sullivan, MD: Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
Genevieve M. Boland, MD, PhD: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Masssachusetts
Lu Si, MD: Department of Melanoma and Sarcoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education, Beijing), Peking University Cancer Hospital and Institute, Beijing, China; Correspondence to: Lu Si, MD, Department of Melanoma & Sarcoma, Peking University Cancer Hospital and Institute, 52 Fucheng Rd, Beijing, China 100142.

Journal volume & issue: Vol. 15
pp. 105 – 114

Abstract

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Background: Anti-Program-Death-1 (PD-1) is a standard adjuvant therapy for patients with resected melanoma. We hypothesized that there are discrepancies in survival, recurrence pattern and toxicity to adjuvant PD-1 between different ethnicities and melanoma subtypes. Objective: We performed a multicenter cohort study incorporating 6 independent institutions in Australia, China, Japan, and the United States. The primary outcomes were recurrence free survival (RFS) and overall survival (OS). Secondary outcomes were disease recurrence patterns and toxicities. Results: In total 534 patients were included. East-Asian/Hispanic/African reported significantly poorer RFS/OS. Nonacral cutaneous or melanoma of unknown primary reported the best RFS/OS, followed by acral, and mucosal was the poorest. Within the nonacral cutaneous or melanoma of unknown primary subtypes, East-Asian/Hispanic/African reported significantly poorer RFS/OS than Caucasian. In the multivariate analysis incorporating ethnicity/melanoma-subtype/age/sex/stage/lactate dehydrogenase/BRAF (v-Raf murine sarcoma viral oncogene homolog B)-mutation/adjuvant radiotherapy, East-Asian/Hispanic/African had independently significantly poorer outcomes (RFS: HR, 1.71; 95% CI, 1.19-2.44 and OS: HR, 2.34; 95% CI, 1.39-3.95), as was mucosal subtype (RFS: HR, 3.25; 95% CI, 2.04-5.17 and OS: HR, 3.20; 95% CI, 1.68-6.08). Mucosal melanoma was an independent risk factor for distant metastasis, especially liver metastasis. East-Asian/Hispanic/African had significantly lower incidence of gastrointestinal/musculoskeletal/respiratory/other-rare-type-toxicities; but higher incidences of liver toxicities. Limitations: A retrospective study. Conclusions: Ethnicity and melanoma subtype are associated with survival and recurrence pattern in melanoma patients treated with adjuvant anti-PD-1. Toxicity profile differs by ethnicity and may require a precision toxicity surveillance strategy.

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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