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Skin Cancer

Skin Cancer

Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
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Adverse Events in Anti-PD-1-Treated Adjuvant and First-Line Advanced Melanoma Patients.

Daan Jan Willem Rauwerdink¹, Olivier van Not^1,2, Melissa de Meza³

¹Department of Dermatology, Leiden University Medical Center, Leiden University, Albinusdreef 2, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

|August 10, 2024

Summary

Adjuvant anti-PD-1 therapy for melanoma does not increase the risk of severe immune-related adverse events (irAEs) compared to advanced treatment. However, comorbidities and poor performance status independently raise the risk of irAEs in both settings.

Keywords:

immune checkpoint inhibitors melanoma side-effects

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Area of Science:

Oncology
Immunology
Clinical Trials

Background:

Immune-related adverse events (irAEs) are common with anti-PD-1 therapy in melanoma.
The comparative risk of irAEs between adjuvant and advanced melanoma treatment settings is not well-established.
Understanding these differences is crucial for patient counseling and treatment management.

Purpose of the Study:

To compare the incidence and severity of irAEs in melanoma patients receiving anti-PD-1 therapy in adjuvant versus advanced settings.
To identify patient-specific factors associated with the development of severe irAEs.

Main Methods:

Multi-center cohort study of 2373 melanoma patients treated with anti-PD-1 (2015-2021).
Analysis included assessment of comorbidities and ECOG performance status prior to treatment.
Grade III-IV irAEs were monitored, and univariate/multivariate regression analyses were performed.

Main Results:

Adjuvant patients were younger (63 vs 69 years) and had better ECOG status than advanced patients.
Grade III-IV irAEs occurred in 13% of adjuvant patients and 15% of advanced patients.
Comorbidities (aOR 1.22) and ECOG > 1 (aOR 2.00) were associated with increased severe irAE risk; adjuvant therapy was not (aOR 0.95).

Conclusions:

Higher ECOG performance status and comorbidities are independent risk factors for severe irAEs in both adjuvant and advanced melanoma.
Adjuvant anti-PD-1 therapy is not associated with a higher risk of severe irAEs compared to advanced treatment.
Findings are clinically significant for patient consultation regarding adjuvant anti-PD-1 therapy.