Purpose
We investigated the clinical efficacy of immune checkpoint blocker (ICB) therapy for metastatic or advanced melanoma in Korean patients. As well, we assessed whether the effects of ICBs can be enhanced by combination therapy with palliative radiotherapy (RT).
Materials and Methods
We retrospectively reviewed the records of 127 patients with metastatic melanoma who received ICB with or without palliative RT between 2014 and 2018. The melanoma subtypes were classified as follows: chronic sun-damaged (CSD), acral, mucosal, and uveal. The primary endpoint was the objective response rate (ORR).
Results
The overall ORR was 15%, with 11 complete and eight partial responses. ORRs for CSD, acral/mucosal, and uveal melanomas were 50%, 16.5%, and 0%, respectively (p=0.009). In addition to the subtype, stage at treatment, total tumor burden at treatment, and ICB type were significantly associated with ORR (all p < 0.05). Palliative RT was administered in 44% of patients during the treatment, and it did not affect ORR. Clinical responders to ICB therapy exhibited significantly higher 1-year progression-free and overall survival rates than nonresponders.
Conclusion
ORR for ICB monotherapy in Korean patients with melanoma is relatively modest compared with that in Western patients because the non-CSD subtypes are predominant in the Korean population. Our findings regarding combination therapy with ICB provided a rationale for the initiation of our phase II study (NCT04017897).
Citations
Citations to this article as recorded by
Hydrogels as a Potential Biomaterial for Multimodal Therapeutic Applications Harpreet Kaur, Bishmita Gogoi, Ira Sharma, Deepak Kumar Das, Mohd Ashif Azad, Devlina Das Pramanik, Arindam Pramanik Molecular Pharmaceutics.2024; 21(10): 4827. CrossRef
Injectable hydrogels for personalized cancer immunotherapies Neda Mohaghegh, Amir Ahari, Fatemeh Zehtabi, Claire Buttles, Saya Davani, Hanna Hoang, Kaylee Tseng, Benjamin Zamanian, Safoora Khosravi, Ariella Daniali, Negar Hosseinzadeh Kouchehbaghi, Isabel Thomas, Hamed Serati Nouri, Danial Khorsandi, Reza Abbasghol Acta Biomaterialia.2023; 172: 67. CrossRef
Efficacy of radiotherapy combined with immune checkpoint inhibitors in patients with melanoma: a systemic review and meta-analysis Gaofei Yin, Wei Guo, Zhigang Huang, Xiaohong Chen Melanoma Research.2022; 32(2): 71. CrossRef
The pharmacotherapeutic management of nail unit and acral melanomas Julianne M. Falotico, Shari R. Lipner Expert Opinion on Pharmacotherapy.2022; 23(11): 1273. CrossRef
A Comparison of 2 Disease Burden Assessment Methods (3D Volume Versus the Number of Lesions) for Prognostication of Survival in Metastatic Melanoma: Implications for the Characterization of Oligometastatic Disease Jina Kim, Jee Suk Chang, Wonmo Sung, Jin Sung Kim, Tae Hyung Kim, Seo Hee Choi, Kyung Hwan Kim, Heejoo Ko, Hye Sun Lee, Soyoung Jeon, Sang Joon Shin, Mitchell Liu, Robert Olson International Journal of Radiation Oncology*Biology*Physics.2022; 114(5): 883. CrossRef
Prediction of Immune-Checkpoint Blockade Monotherapy Response in Patients With Melanoma Based on Easily Accessible Clinical Indicators Hwa Kyung Byun, Jee Suk Chang, Minkyu Jung, Woong Sub Koom, Kee Yang Chung, Byung Ho Oh, Mi Ryung Roh, Kyung Hwan Kim, Choong-Kun Lee, Sang Joon Shin Frontiers in Oncology.2021;[Epub] CrossRef
Effectiveness and safety of immune checkpoint inhibitors in combination with palliative radiotherapy in advanced melanoma: A systematic review Jennifer Ben Shimol, Yuli Guzman-Prado, Maria Karlinskaya, Tima Davidson Critical Reviews in Oncology/Hematology.2021; 167: 103499. CrossRef
Purpose
Melanoma is a highly heterogeneous neoplasm, composed of subpopulations of tumor cells with distinct molecular and biological phenotypes and genotypes. In this study, to determine the genetic heterogeneity between primary and metastatic melanoma in Korean melanoma patients, we evaluated several well-known genetic alterations of melanoma. In addition, to elucidate the clinical relevance of each genetic alteration and heterogeneity between primary and metastatic lesions, clinical features and patient outcome were collected.
Materials and Methods
In addition to clinical data, BRAF, NRAS, GNAQ/11 mutation and KIT amplification data was acquired from an archived primary Korean melanoma cohort (KMC) of 188 patients. Among these patients, 43 patients were included for investigation of tumor heterogeneity between primary melanoma and its corresponding metastatic lesions.
Results
Overall incidence of genetic aberrations of the primary melanomas in KMC was 17.6% of BRAF V600, 12.6% of NRAS mutation, and 28.6% of KIT amplification. GNAQ/11 mutation was seen in 66.6% of the uveal melanoma patients. Patients with BRAF mutation were associated with advanced stage and correlated to poor prognosis (p < 0.01). Among 43 patients, 55.8% showed heterogeneity between primary and metastatic lesion. The frequency of BRAF mutation and KIT amplification significantly increased in the metastatic lesions compared to primary melanomas. Conclusion
Our data demonstrated heterogeneity between primary melanomas and corresponding metastatic lesions for BRAF, NRAS mutation and KIT amplification. However, GNAQ/11 mutation was genetically homogeneous between primary and metastatic melanoma lesions in uveal melanoma.
Citations
Citations to this article as recorded by
Elucidation of anti-human melanoma and anti-aging mechanisms of compounds from green seaweed Caulerpa racemosa Danar Wicaksono, Nurpudji Astuti Taslim, Vincent Lau, Rony Abdi Syahputra, Aiman Idrus Alatas, Purnawan Pontana Putra, Trina Ekawati Tallei, Raymond Rubianto Tjandrawinata, Apollinaire Tsopmo, Bonglee Kim, Fahrul Nurkolis Scientific Reports.2024;[Epub] CrossRef
Évolution du statut braf dans le melanome : mythe ou Réalité ? Elicia Molines, Aurélie Haffner, Frédéric Fina, Nausicaa Malissen, L’Houcine Ouafik, Jean-Jacques Grob, Nicolas Macagno Annales de Pathologie.2022; 42(2): 113. CrossRef
Metastatic uveal melanoma: The final frontier Elina S. Rantala, Micaela M. Hernberg, Sophie Piperno-Neumann, Hans E. Grossniklaus, Tero T. Kivelä Progress in Retinal and Eye Research.2022; 90: 101041. CrossRef
Variations in genetics, biology, and phenotype of cutaneous disorders in skin of color – Part I: Genetic, biologic, and structural differences in skin of color Jessica B. Brown-Korsah, Shanice McKenzie, Deega Omar, Nicole C. Syder, Nada Elbuluk, Susan C. Taylor Journal of the American Academy of Dermatology.2022; 87(6): 1239. CrossRef
PTEN Promoter Hypermethylation Is Associated with Breslow Thickness in Acral Melanoma on the Heel, Forefoot, and Hallux Hae Seok Park, Jong Hoon Kim, Mi Yeon Cho, Kee Yang Chung, Mi Ryung Roh Annals of Dermatology.2021; 33(1): 18. CrossRef
Heterogeneity of GNAQ/11 mutation inversely correlates with the metastatic
rate in uveal melanoma Chen Liang, Lan ya Peng, Ming Zou, Xuemei Chen, Yingying Chen, Hou Chen, Lirong Xiao, Naihong Yan, Junjun Zhang, Qing Zhao, Xi Huang British Journal of Ophthalmology.2021; 105(4): 587. CrossRef
Topical MTII Therapy Suppresses Melanoma Through PTEN Upregulation and Cyclooxygenase II Inhibition Jian-Ching Wu, Han-En Tsai, Yi-Hsiang Hsiao, Ji-Syuan Wu, Chieh-Shan Wu, Ming-Hong Tai International Journal of Molecular Sciences.2020; 21(2): 681. CrossRef
Male sex and Breslow thickness are important risk factors for recurrence of localized melanoma in Korean populations Yeongjoo Oh, Sooyie Choi, Mi Yeon Cho, Kyoung Ae Nam, Sang Joon Shin, Jee Suk Chang, Byung Ho Oh, Mi Ryung Roh, Kee Yang Chung Journal of the American Academy of Dermatology.2020; 83(4): 1071. CrossRef
Tumor Heterogeneity on FDG PET/CT and Immunotherapy: An Imaging Biomarker for Predicting Treatment Response in Patients With Metastatic Melanoma Y. Sanli, J. Leake, A. Odu, Y. Xi, R. M. Subramaniam American Journal of Roentgenology.2019; 212(6): 1318. CrossRef
BRAF and NRAS mutations and antitumor immunity in Korean malignant melanomas and their prognostic relevance: Gene set enrichment analysis and CIBERSORT analysis Kyueng-Whan Min, Ji-Young Choe, Mi Jung Kwon, Hye Kyung Lee, Ho Suk Kang, Eun Sook Nam, Seong Jin Cho, Hye-Rim Park, Soo Kee Min, Jinwon Seo, Yun Joong Kim, Nan Young Kim, Ho Young Kim Pathology - Research and Practice.2019; 215(12): 152671. CrossRef
Molecular and genetic diversity in melanoma of eye N. N. Mazurenko, I. V. Tsyganova, V. V. Nazarova, I. A. Utyashev, K. V. Orlova, D. A. Ponkratova, D. V. Martinkov, L. V. Demidov Advances in molecular oncology.2018; 5(3): 51. CrossRef