Abstract
Background: Immune checkpoint inhibitors (ICI) revolutionized treatment of advanced melanoma, but are associated with significant toxicities. Cutaneous immune-related adverse events (cirAEs) are the most common. Despite this, the association of cirAEs on morbidity and mortality remains underexplored. Here, we examine the impact of melanoma subtype on cirAE onset and survival among ICI recipients in a multi-institutional, retrospective cohort study. Methods: We identified 765 metastatic melanoma patients in the Mass General Brigham Healthcare System who received ICI treatment between December 2011 and May 2020. CirAE development was determined through manual chart abstraction. Multivariate time-series regressions were used to assess relationships between primary melanoma subtypes (acral, mucosal, and non-acral/non-mucosal cutaneous melanomas-controls), cirAE development, and survival, adjusting for age at ICI initiation, sex, race/ethnicity, ICI-type, and Charleston Comorbidity Index. Results: 241 patients (31.5%) developed a cirAE. The mean time to cirAE onset after ICI initiation was longer for acral melanoma patients compared with controls (15.6 vs. 3.6 months, P < .001). After covariate adjustment, acral melanoma patients were significantly less likely to develop a cirAE (HR = 0.42 P = .038) compared with controls. Mucosal melanoma patients were more likely to develop a cirAE compared with controls, but this association did not reach significance after covariate adjustment (HR = 1.38, P = .125). CirAE presence was protective from mortality (HR = 0.74, P = .049) for all patients. Additionally, metastatic melanoma patients with acral (HR = 2.13, P = .001) or mucosal (HR = 1.90, P < .001) primaries exhibited the worst survival. Conclusion: This study demonstrates significant differences in cirAE development and survival among melanoma subtypes and can inform clinicians when counseling melanoma patients.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
