背景:辅助治疗改善了术后黑色素瘤患者的临床预后。然而,在之前的试验中,该疗法对黑色素瘤肢端和粘膜亚型的长期疗效尚未得到充分评估.这项研究评估了黑色素瘤患者的3年无复发生存率和总生存率。包括肢端和粘膜亚型,用抗PD-1抗体(Ab)或BRAF和MEK抑制剂dabrafenib和trametinib的组合治疗。
方法:我们回顾性分析了120例抗PD-1抗体(Ab)治疗患者的3年复发时间(TTR)和总生存期(OS),或与dabrafenib和trametinib的组合。
结果:总TTR中位数为18.4个月,范围为0.69到36个月。肢端和粘膜类型的3年TTR分别为28.1%和38.5%,分别。在亚组分析中,基线肿瘤厚度(TT)和肢端类型与TTR相关。此外,在多项分析中,我们将104例肢端和非肢端皮肤患者分为抗PD-1Abs或dabrafenib+trametinib联合治疗队列.肢端亚型和TT是重要的预后因素。在3年操作系统中,在单变量和多重分析中,只有肿瘤溃疡与OS相关.粘膜类型的基线或治疗相关因素没有显着差异(p>0.05)。
结论:这项研究表明,在3年TTR终点时,非肢端皮肤黑色素瘤的辅助治疗比肢端或粘膜类型更有效。
BACKGROUND: Adjuvant therapy has improved the clinical prognosis for postoperative melanoma patients. However, the long-term efficacy of this therapy on the melanoma
acral and mucosal subtypes has not been fully evaluated in previous trials. This study assessed the 3-year recurrence-free survival and overall survival of patients with melanoma, including the acral and mucosal subtypes, treated with anti-PD-1 antibody (Ab) or with the combination of the BRAF and MEK inhibitors dabrafenib and trametinib.
METHODS: We retrospectively analyzed both the 3-year time to relapse (TTR) and overall survival (OS) of 120 patients treated with anti-PD-1 antibody (Ab), or with the combination of dabrafenib and trametinib.
RESULTS: The overall median TTR was 18.4 months, with a range of 0.69 to 36 months. The 3-year TTR of the
acral and mucosal types was 28.1% and 38.5%, respectively. Baseline tumor thickness (TT) and acral type were associated with the TTR in subgroup analysis. Moreover, we classified 104
acral and non-
acral cutaneous patients into the anti-PD-1 Abs or dabrafenib plus trametinib combined therapies cohort in multiple analyses. The
acral subtype and TT were detected as important prognostic factors. In the 3-year OS, only tumor ulceration was associated with the OS in both univariate and multiple analyses. There was no significant difference in baseline or treatment-related factors of the mucosal type (p > 0.05).
CONCLUSIONS: This study suggests that adjuvant therapy is more effective with non-acral cutaneous melanoma than either the
acral or mucosal types at the 3-year TTR endpoint.