학술논문
Efficacy of salvage therapies for advanced acral melanoma after anti-PD-1 monotherapy failure: a multicenter retrospective study of 108 Japanese patients
Document Type
article
Author
Tatsuhiko Mori; Kenjiro Namikawa; Naoya Yamazaki; Yukiko Kiniwa; Osamu Yamasaki; Shusuke Yoshikawa; Takashi Inozume; Hiroshi Kato; Yasuo Nakai; Satoshi Fukushima; Tatsuya Takenouchi; Takeo Maekawa; Shigeto Matsushita; Atsushi Otsuka; Motoo Nomura; Natsuki Baba; Taiki Isei; Shintaro Saito; Noriki Fujimoto; Ryo Tanaka; Takahide Kaneko; Yutaka Kuwatsuka; Taisuke Matsuya; Kotaro Nagase; Masazumi Onishi; Takehiro Onuma; Yasuhiro Nakamura
Source
Frontiers in Medicine, Vol 10 (2023)
Subject
Language
English
ISSN
2296-858X
Abstract
BackgroundAnti-programmed cell death protein 1 (PD-1) monotherapy is one of the standard systemic therapies for advanced melanoma; however, the efficacy of salvage systemic therapies after PD-1 monotherapy failure (PD-1 MF), particularly in acral melanoma (AM), the main clinical melanoma type in Japanese patients, is unclear. This study aimed to investigate the efficacy of salvage systemic therapies in Japanese patients with AM after PD-1 MF.Patients and methodsThe study included 108 patients with advanced AM (palm and sole, 72; nail apparatus, 36) who underwent salvage systemic therapy at 24 Japanese institutions. We mainly assessed the objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).ResultsThirty-six (33%) patients received ipilimumab, 23 (21%) received nivolumab and ipilimumab (nivo/ipi), 10 (9%) received cytotoxic chemotherapy, 4 (4%) received BRAF and MEK inhibitors (BRAFi/MEKi), and the remaining 35 (32%) continued with PD-1 monotherapy after disease progression. The ORRs in the ipilimumab, nivo/ipi, cytotoxic chemotherapy, and BRAFi/MEKi groups were 8, 17, 0, and 100%, respectively. The nivo/ipi group showed the longest OS (median, 18.9 months); however, differences in ORR, PFS, and OS between the groups were insignificant. The OS in the nivo/ipi group was higher in the palm and sole groups than in the nail apparatus group (median: not reached vs. 8.7 months, p