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Immune checkpoint inhibitors in the treatment of advanced mucosal melanoma
1Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario M5G 2M9, Canada.
Abstract:
Immunotherapy with immune checkpoint inhibitors is the standard of care in the treatment of advanced melanoma. Treatment outcome of these agents is less defined for the rare subtype of mucosal melanoma. In this single-institutional case series, the objective response rate was low at 11.8%, but durable response was seen, including a complete response to first-line ipilimumab and to second-line pembrolizumab. Survival remained poor; at the median follow-up of 10.1 months, the median progression-free survival and overall survival were 3.1 and 8.8 months respectively. Nevertheless, among the few responders, survival of up to 56+ months was observed. Other treatment strategies need to be explored to improve treatment outcome for this rare subtype.
Insights
Immune checkpoint inhibitors show limited response in mucosal melanoma, a rare cancer. Durable responses occurred, but overall survival remains poor, necessitating novel treatment strategies.
Area of Science:
- Oncology
- Immunology
Background:
- Immune checkpoint inhibitors (ICIs) are standard for advanced melanoma.
- Their efficacy in mucosal melanoma, a rare subtype, is less understood.
Observation:
- This case series evaluated ICI treatment in mucosal melanoma patients.
- Objective response rate was 11.8%.
Findings:
- Durable responses, including complete responses, were observed with ipilimumab and pembrolizumab.
- Median progression-free survival was 3.1 months, and median overall survival was 8.8 months.
- Long-term survival exceeding 56 months was noted in a subset of responders.
Implications:
- Current ICI strategies yield poor survival outcomes for most mucosal melanoma patients.
- Exploring alternative or combination therapies is crucial for improving treatment efficacy.
- Further research is needed to identify predictive biomarkers for response in this rare melanoma subtype.
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