Immune Checkpoint Inhibition Among Patients With Dermatologic and Hematologic Cancers
Posted: Wednesday, December 2, 2020
Immune checkpoint inhibitors appear to be efficacious in patients with skin cancer who have a concurrent hematologic malignancy; however, the effect seemed to be impaired among patients with cutaneous squamous cell carcinoma but not with metastatic melanoma or Merkel cell carcinoma. Selma Ugurel, MD, of the University of Duisburg-Essen, Germany, and her colleagues published this study in the Journal for ImmunoTherapy of Cancer.
This retrospective, multicenter study included 84 patients with metastatic melanoma (n = 52), cutaneous squamous cell carcinoma (n = 15), or Merkel cell carcinoma (n = 17) who had a previous hematologic malignancy diagnosis (70 with non-Hodgkin lymphoma and 32 with chronic lymphocytic leukemia). A control group without a hematologic malignancy was identified from the prospective multicenter skin cancer registry ADOREG.
Among this cohort, 9 received immunotherapy in an adjuvant setting, whereas 75 were treated for advanced nonresectable malignancies. Patients were treated with anti–PD-1 therapy (n = 55), anti–PD-L1 therapy (n = 8), anticytotoxic T-lymphocyte–associated protein 4 therapy (n = 5), or a combination regimen (n = 7) for their primary skin malignancies. Within the group of patients treated for nonresectable tumors, the best objective response (complete response plus partial response) was 28.0%, and disease stabilization was 25.3%. Progressive disease was noted among 38.6% of patients. The best objective response was seen among patients with metastatic melanoma (31.1%), whereas those with cutaneous squamous cell and Merkel cell carcinomas had an objective response of 26.7% and 18.8%, respectively. The median progression-free survival was 8.4 months, 4.0 months, and 5.7 months among patients with melanoma, squamous cell carcinoma, and Merkel cell carcinoma, respectively.
In comparison to the 392 patients without a hematologic malignancy, there was no difference in immunotherapy outcomes for patients with Merkel cell carcinoma or malignant melanoma. However, those with squamous cell carcinoma had a significantly reduced progression-free survival when compared with counterparts without hematologic malignancies (P = .002).
Disclosure: For a full list of authors’ disclosures, visit jitc.bmj.com.