Li Tong, Xu Yu, Sun Wei, Yan Wangjun, Wang Chunmeng, Hu Tu, Zhang Xiaowei, Luo Zhiguo, Liu Xin, Chen Yong
Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Pharmaceuticals (Basel). 2022 Dec 28;16(1):41. doi: 10.3390/ph16010041.
The use of adjuvant therapy has provided survival benefits in patients with advanced melanoma. This study aimed to explore the recurrence and prognosis of the PD-1 inhibitor, conventional interferon (IFN), or observation (OBS) on resected stage III acral and cutaneous melanoma patients through a retrospective analysis. Patients with resected stage III melanoma at Fudan University Shanghai Cancer Center from 2017 to 2021 were enrolled with all of their clinicopathologic characteristics collected. They were divided into three groups: PD-1 inhibitor, IFN, and OBS. Survival analyses were performed to indicate the significance of different adjuvant therapies. A total of 199 patients were enrolled (PD-1 n = 126; IFN n = 31; and OBS n = 42), with their median follow-up times being 21 months, 24 months, and 49 months, respectively. The PD-1 inhibitor significantly improved relapse-free survival ( = 0.027) and overall survival ( = 0.033) compared with conventional treatment (IFN+OBS). The superiority of the PD-1 inhibitor was witnessed in stage IIIC/D ( = 0.000) acral ( = 0.05) melanoma patients with ulceration ( = 0.011) or lymph node macrometastasis ( = 0.010). The PD-1 inhibitor significantly reduced local recurrence and systemic metastasis compared with conventional therapy ( = 0.002). In conclusion, adjuvant anti-PD-1 immunotherapy can achieve better survival outcomes in acral and cutaneous melanoma patients compared with conventional treatment, without considering adverse events. More clinical benefits were seen in later-stage acral melanoma patients with ulceration or lymph node macrometastasis.
辅助治疗已为晚期黑色素瘤患者带来了生存获益。本研究旨在通过回顾性分析，探讨PD-1抑制剂、传统干扰素（IFN）或观察等待（OBS）对切除术后的III期肢端和皮肤黑色素瘤患者的复发情况及预后。纳入了2017年至2021年在复旦大学附属肿瘤医院接受切除术后的III期黑色素瘤患者，并收集了他们所有的临床病理特征。将他们分为三组：PD-1抑制剂组、IFN组和OBS组。进行生存分析以表明不同辅助治疗的意义。共纳入199例患者（PD-1组n = 126；IFN组n = 31；OBS组n = 42），其随访时间中位数分别为21个月、24个月和49个月。与传统治疗（IFN + OBS）相比，PD-1抑制剂显著改善了无复发生存期（P = 0.027）和总生存期（P = 0.033）。在IIIC/D期（P = 0.000）、有溃疡（P = 0.05）或淋巴结大转移（P = 0.010）的肢端（P = 0.011）黑色素瘤患者中，可见PD-1抑制剂的优势。与传统治疗相比，PD-1抑制剂显著降低了局部复发和远处转移（P = 0.002）。总之，与传统治疗相比，辅助性抗PD-1免疫治疗可使肢端和皮肤黑色素瘤患者获得更好的生存结局，且不考虑不良事件。在有溃疡或淋巴结大转移的晚期肢端黑色素瘤患者中可观察到更多的临床获益。
