The Effect of Perioperative Cimetidine on the Outcomes of Stage 2 Melanoma

Abstract

Objectives The use of immunotherapies in the treatment of melanoma has significantly improved the survival of patients with advanced disease. Historically, histamine has been implicated in the pathogenesis of several cancers. Cimetidine does play a role in modulating the immune system and was advocated as an immunotherapeutic agent since the 1970s. Cimetidine has been showing promise in conjunction with standard care in many cancers in vitro and in vivo. However, its effects in melanoma have not been explored yet. Our study was designed to determine if cimetidine taken in the perioperative period improves the disease-free survival (DFS) or overall survival in patients with the American Joint Committee on Cancer, seventh edition (AJCC 7) stage 2 melanoma. Materials and Methods We have reviewed all the patients with stage 2 melanoma in our center in a retrospective cohort to assess the difference in survival between patients who received H2 blockers in the perioperative period and those who did not. Statistical Analysis and Results Thirty-two patients were included in the analysis. Nine of 32 patients received H2 blockers in the perioperative period. All the patients were males except for one female in the control group (4.3%). The age in the analyzed population ranged between 51 and 92 years; the median age was 70 years (mean: 71; standard deviation: 10). The median overall survival of the patients who received H2 blockers was 112.7 months and it was 77.2 months for those who did not receive H2 blockers. There was no difference in DFS between the two groups (p = 0.5395), and there was no difference in the overall survival (p = 0.4770). The cumulative dose was strongly correlated with the overall survival in the patients who received H2 blockers (r = 0.8341, p = 0.0196). Conclusion Despite having a small treatment group, we were able to detect a strong correlation between the cumulative dose of H2 blockers received and the overall survival.