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). Conclusion: 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.
背景：辅助治疗改善了术后黑色素瘤患者的临床预后。然而，既往试验尚未充分评估该疗法对肢端型和黏膜型黑色素瘤亚型的长期疗效。本研究评估了接受抗PD-1抗体或BRAF/MEK抑制剂达拉非尼联合曲美替尼治疗的黑色素瘤患者（包括肢端型和黏膜型亚型）的3年无复发生存期和总生存期。方法：我们回顾性分析了120例接受抗PD-1抗体或达拉非尼联合曲美替尼治疗患者的3年复发时间与总生存期。结果：总体中位复发时间为18.4个月（范围0.69-36个月）。肢端型和黏膜型患者的3年无复发生存率分别为28.1%和38.5%。亚组分析显示基线肿瘤厚度和肢端型与复发时间相关。此外，我们在多变量分析中将104例肢端型与非肢端型皮肤黑色素瘤患者纳入抗PD-1抗体或达拉非尼联合曲美替尼治疗队列，发现肢端亚型和肿瘤厚度是重要的预后因素。在3年总生存期分析中，单变量与多变量分析均显示仅肿瘤溃疡与总生存期相关。黏膜型患者的基线特征或治疗相关因素均无显著差异（p>0.05）。结论：本研究提示在3年无复发生存终点上，辅助治疗对非肢端型皮肤黑色素瘤的疗效优于肢端型或黏膜型亚型。
肿瘤(癌症)患者之家