Identifying patients likely to benefit from immune checkpoint inhibitor (ICI) treatment remains a crucial goal for melanoma. The objective of this study is to assess the association between primary tumor features and immunotherapy response and survival in advanced melanoma patients. In this single-center retrospective cohort study, disease characteristics, response to immunotherapy, PFS, and OS were assessed among melanoma patients (excluding mucosal and uveal primaries) treated with ICI. Among 447 patients, 300 (67.1%) received anti-PD-1 monotherapy and 147 (32.9%) received ipilimumab/nivolumab. A total of 338 (75.6%) had cutaneous melanoma, 29 (6.5%) had acral melanoma, and 80 (17.9%) had melanoma of unknown primary. Ulceration and stage at initial presentation were associated with inferior outcomes on univariate analysis. However, on multivariate analysis, this result was not observed, but cutaneous melanoma and each of its subtypes (superficial spreading, nodular, other, unknown) were positively associated with response, longer PFS, and longer OS. Metastatic stage (M1c, M1d) at presentation (OR = 1.8,p< 0.05) andBRAFV600Emutation status (OR = 1.6,p< 0.001) were associated with shorter PFS. This study is limited by its retrospective and single-center design. Cutaneous melanoma and its subtypes were significantly associated with response, PFS, and OS compared with acral or unknown primary melanoma.
确定可能从免疫检查点抑制剂（ICI）治疗中获益的患者仍是黑色素瘤治疗的关键目标。本研究旨在评估晚期黑色素瘤患者原发肿瘤特征与免疫治疗反应及生存期之间的关联。在这项单中心回顾性队列研究中，我们分析了接受ICI治疗的黑色素瘤患者（排除黏膜和葡萄膜原发肿瘤）的疾病特征、免疫治疗反应、无进展生存期（PFS）和总生存期（OS）。在447例患者中，300例（67.1%）接受抗PD-1单药治疗，147例（32.9%）接受伊匹木单抗/纳武利尤单抗联合治疗。其中338例（75.6%）为皮肤黑色素瘤，29例（6.5%）为肢端黑色素瘤，80例（17.9%）为原发灶不明黑色素瘤。单因素分析显示溃疡和初诊分期与不良预后相关，但多因素分析未观察到这一结果，反而发现皮肤黑色素瘤及其各亚型（浅表扩散型、结节型、其他型、未知型）与治疗反应、更长PFS和更长OS呈正相关。初诊时转移分期（M1c、M1d）（OR=1.8，p<0.05）和BRAF V600E突变状态（OR=1.6，p<0.001）与较短PFS相关。本研究的局限性在于其回顾性单中心设计。与肢端或原发灶不明黑色素瘤相比，皮肤黑色素瘤及其亚型与治疗反应、PFS和OS存在显著正相关。
肿瘤(癌症)患者之家