Investigating the role of immunotherapy in advanced/recurrent female genital tract melanoma: a preliminary experience

Indini, Alice; Guardo, Lorenza Di; Cimminiello, Carolina; Lorusso, Domenica; Raspagliesi, Francesco; Vecchio, Michele Del

doi:10.3802/jgo.2019.30.e94

Cited by 36 publications

(35 citation statements)

References 31 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Female genitourinary tract melanomas account for 3% of all melanomas [ 75 ]. The vulva is the most frequent site involved (70%), followed by the vagina and, more rarely, the cervix [ 76 ]. Although genital melanomas can occur at any age, a mean age at diagnosis of 60 years has been reported [ 77 , 78 ].…”

Section: Mucosal Melanomas At Uncommon Sitesmentioning

confidence: 99%

“…The available data mainly consist of small retrospective series and support the use of immunotherapy in improving survival. Indini et al (2019), in a single center experience including seven female lower genital tract melanomas, reported a poor response rate for immunotherapy (28.5%) [ 76 ]. A better progression-free survival and overall survival was observed in patients under anti-PD-1 therapy compared to those receiving anti-CTLA4 ( p = 0.01 and p = 0.15, respectively) [ 76 ].…”

Section: Mucosal Melanomas At Uncommon Sitesmentioning

confidence: 99%

“…The c-KIT inhibitor imatinib is the most-studied adjuvant therapy and has so far shown only a suboptimal response in trials of mucosal melanomas. Some authors reported that immunotherapy (anti-PD-1) combined with other therapies (ipilimumab, radiation therapy or imatinib) are associated with better results in the adjuvant setting than both agents alone [ 75 , 76 ].…”

Section: Mucosal Melanomas At Uncommon Sitesmentioning

confidence: 99%

See 2 more Smart Citations

Cutaneous and Mucosal Melanomas of Uncommon Sites: Where Do We Stand Now?

Dika

Lambertini

Pellegrini

et al. 2021

JCM

View full text Add to dashboard Cite

Melanomas arising at uncommon sites include a group of lesions related to unusual localizations in specific ethnic groups. The rarity of the disease often represents a limit to the participation of patients in specific trials. However, this peculiar genetic scenario has important therapeutic implications regarding new oncologic therapies. The aim of this article is to review the clinical features, somatic alterations and therapeutic options for melanomas of uncommon sites. They can be classified as cutaneous and mucosal lesions affecting the nail apparatus, palms/soles, oral mucosa, genital area and scalp. The prognosis may be worse compared to melanomas of other districts, and a prompt diagnosis may dramatically influence the outcome. Dermatologists and oncologists should therefore distinguish this melanoma subgroup in terms of surgical intervention and medical treatment. Due to the lack of mutations in genes usually found in cutaneous melanomas, the discovery of novel targets is required to develop new strategies and to change the prognosis of non-responders or wild-type patients.

show abstract

Section: Mucosal Melanomas At Uncommon Sitesmentioning

confidence: 99%

Section: Mucosal Melanomas At Uncommon Sitesmentioning

confidence: 99%

Section: Mucosal Melanomas At Uncommon Sitesmentioning

confidence: 99%

See 1 more Smart Citation

Cutaneous and Mucosal Melanomas of Uncommon Sites: Where Do We Stand Now?

Dika

Lambertini

Pellegrini

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…In addition, 13 patients with VVM receiving immune checkpoint inhibitors were identified from previously published cases in the literature 15 – 20 ; 10 patients with metastatic or unresectable VVM were included (see Table 3 ); 3 patients, who received neoadjuvant ipilimumab and radiation and subsequently underwent surgery, were not included. 20 The best overall ORR with immune checkpoint inhibitors in the combined cohort of the 23 patients was 30.4% (95% CI = 11.6%–49.2%), and the CBR was 52.2% (95% CI = 31.8%–72.6%).…”

Section: Resultsmentioning

confidence: 99%

Clinical Characteristics and Treatment Response With Checkpoint Inhibitors in Malignant Melanoma of the Vulva and Vagina

Wohlmuth

Wohlmuth-Wieser

Laframboise

2020

J Low Genit Tract Dis

View full text Add to dashboard Cite

Objectives The aims of the study were to assess the clinical and histopathological characteristics of a comprehensive cohort of women with vulvovaginal melanoma (VVM) treated at our institution and to study the treatment response of checkpoint inhibitors in this patient cohort. Materials and Methods This is a retrospective study of women with invasive VVM treated at the Princess Margaret Cancer Centre in Toronto, Ontario, Canada, over a period of 15 years. Clinical and histopathological characteristics, treatment, as well as treatment-related outcome were analyzed in 32 women. Treatment response was evaluated retrospectively using the “response criteria for use in trials testing immunotherapeutics” (iRECIST). The objective response rate was defined as the proportion of patients with complete or partial response based on the best overall response. Results At a median follow-up of 37.8 months (5.8–110.4), 26 women (81.3%) had disease progression and 16 (50%) died. Thirteen patients with locally unresectable or metastatic melanoma were treated with immune checkpoint inhibitors. Ten additional cases were identified from previously published reports. The best objective response rate for immune checkpoint inhibitors was 30.4% (95% CI = 11.6%–49.2%) and the clinical benefit rate was 52.2% (95% CI = 31.8%–72.6%). The clinical benefit rate was significantly better for programmed cell death protein 1 inhibitors (or a combination) compared with ipilimumab alone (Fisher exact, p = .023). Grade 3/4 adverse events were observed in 3 (13.0%) of the 23 patients. Conclusions Women with VVM constitute a high-risk group with poor overall prognosis. Immune checkpoint inhibitors are effective in the treatment of metastatic melanoma in this patient cohort.

show abstract

“…This study included a total of 35 mucosal melanomas, 14 of which vulvovaginal. A small retrospective study of patients with metastatic melanoma of the lower genital tract from Italy showed that the response rate to immunotherapy was 28.5% [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Vulvar melanoma: an analysis of prognostic factors and treatment patterns

et al. 2020

View full text Add to dashboard Cite

Objective Melanoma comprises 5% to 10% of vulvar cancers and prognosis is poor. The purpose of this study was to identify prognostic factors and treatment patterns for vulvar melanoma using the National Cancer Database (NCDB). Methods The NCDB was queried for patients with invasive vulvar melanoma from 2004–2015. Descriptive statistics were generated to describe clinical and treatment details. Multivariable Cox regression and the Kaplan-Meier method were used to examine overall survival (OS). Results 1,917 patients with vulvar melanoma met inclusion criteria. Median follow-up time was 32 months (range, 0–151 months). Older age, larger tumor size, advanced disease stage, increased Charlson-Deyo comorbidity score, and care at a non-academic center were independent predictors for decreased OS. Surgical management of the primary site, lymph node surgery, and insurance provided a significant survival benefit. Use of immunotherapy for vulvar melanoma has increased over time. Two-year OS with immunotherapy in patients with distant metastatic disease was higher, although this did not reach statistical significance (33% vs. 12%, p=0.054). Conclusions Vulvar melanoma has a poor prognosis for those with regional and distant metastatic disease. Extent of disease, tumor size, and patient age are important prognostic factors. Other favorable factors included insurance and surgical management. The use of immunotherapy has increased over time and may improve survival in those with distant disease. These data support further investigation into the role of immunotherapy for vulvar melanoma to optimize outcomes.

show abstract

Investigating the role of immunotherapy in advanced/recurrent female genital tract melanoma: a preliminary experience

Cited by 36 publications

References 31 publications

Cutaneous and Mucosal Melanomas of Uncommon Sites: Where Do We Stand Now?

Cutaneous and Mucosal Melanomas of Uncommon Sites: Where Do We Stand Now?

Clinical Characteristics and Treatment Response With Checkpoint Inhibitors in Malignant Melanoma of the Vulva and Vagina

Vulvar melanoma: an analysis of prognostic factors and treatment patterns

Contact Info

Product

Resources

About