Benefit of immune checkpoint inhibitors as adjuvant treatment for acral melanomas

作者：Damien Sanogo, Romain Levard, Julie Cassecuel, Amir Khammari, G. Quéreux, Florent Grange, Henri Montaudié, F. Brunet‐Possenti, Justine Lavaud, M.‐T. Leccia, G. Jeudy, A. Dompmartin, Brigitte Dréno, J.‐M. L'Orphelin · 发表于：Journal of the European Academy of Dermatology and Venereology · 年份：2025 · DOI：10.1111/jdv.70136 · 被引用次数：2 · 研究领域：Cutaneous Melanoma Detection and Management、Cancer Immunotherapy and Biomarkers、Nonmelanoma Skin Cancer Studies

BACKGROUND: Solar factors play no role in the development of acral melanoma (AM). AM is characterized by low cumulative solar damage (low CSD). Responses to immunotherapy are correlated with mutational load, which, in turn, is correlated with high cumulative sun damage (CSD). This suggests that AM patients may have poor responses to immunotherapy. The clinical benefit and safety profile of adjuvant immunotherapies in AM treatment have not been fully investigated. OBJECTIVES: To investigate whether the use of adjuvant immunotherapy for treating patients with AM in Stages IIb, IIc, III and IV NED (no evidence of disease) improves distant metastasis-free survival. METHODS: Among the 1005 AM patients in the RIC-Mel melanoma database, 64 AM patients who were treated with adjuvant immunotherapy were included in this study. We then calculated a propensity score to make the adjuvant immunotherapy-treated (n = 64) group and the untreated group (n = 64) comparable in all respects. RESULTS: The use of adjuvant immunotherapy for treating AM offers no clear benefit in terms of relapse-free survival or distant metastasis-free survival (RFS: HR = 0.84 [0.534, 1.324, 95% CI] and DMFS: HR = 0.94 [0.565, 1.562, 95% CI]). Among the AM patients who received adjuvant immune checkpoint inhibitors (ICI), 18.8% experienced severe (Grades 3-4) immune-related adverse events. CONCLUSIONS: The benefit-risk balance must be carefully weighed, including the relapse-free survival (RFS), distant metastasis-f...