Extramammary Paget's disease treated with of anti-programmed cell death protein 1 therapy after docetaxel therapy...

Area of Science:

• Oncology
• Dermatology
• Immunotherapy

Background:

• Extramammary Paget's disease (EMPD) is a rare skin malignancy with limited treatment options for advanced stages.
• Docetaxel chemotherapy is a common treatment, but lacks standardization for advanced EMPD.
• Anti-programmed cell death protein 1 (PD-1) therapies are approved for certain cancers based on tumor mutation burden (TMB) or microsatellite instability.

Observation:

• This study presents three advanced EMPD cases treated with anti-PD-1 therapy post-docetaxel.
• Tumor mutation burden (TMB) values for these cases were 17.8, 14.3, and 5.0 mut/Mb.
• A review of similar reported cases was conducted to assess real-world efficacy.

Findings:

• Real-world data indicates insufficient response to anti-PD-1 therapy in EMPD patients, even those with high TMB.
• Most reported cases received anti-PD-1 therapy as second-line or later treatment.
• The efficacy of anti-PD-1 therapy in EMPD remains limited in current real-world evidence.

Implications:

• Further research is crucial to determine the precise effectiveness of anti-PD-1 therapy as a first-line treatment for EMPD.
• Investigating alternative treatment strategies or combinations may be necessary for advanced EMPD.
• The current findings highlight the need for novel therapeutic approaches for this rare skin cancer.