Programmed cell death protein (PD-1) inhibitors constitute the standard adjuvant therapy for cutaneous melanoma (CM), but well-established strategies for acral melanoma (AM) remain limited. To compare the efficacy of adjuvant anti-PD-1 immunotherapy versus high-dose interferon α-2b (HDI) in patients with stage IIB-IV AM and CM. This multicenter, retrospective study enrolled 511 patients with resected stage IIB-IV AM and CM between January 2017 and December 2023. Patients were divided into four groups by subtype and treatment: patients with CM and treated with anti-PD-1 (CM-PD-1), patients with CM and treated with HDI (CM-HDI), patients with AM and treated with anti-PD-1 (AM-PD-1), and patients with AM and treated with HDI (AM-HDI). Recurrence-free survival (RFS), overall survival (OS), and patient safety were evaluated. This study comprised 362 AM and 149 CM cases. AM cases presented with thicker primary lesions, higher ulceration rates, and fewer BRAF mutations. Median follow-up was 49 months. Among patients with stage IIB/C, median RFS was not reached in any groups. Among stage III/IV patients, median RFS was 14.6 (CM-PD-1), 13.7 (CM-HDI), 13.3 (AM-PD-1), and 11.7 months (AM-HDI), and median OS was 61.6, 40.7, 42.4, and 53.4 months, respectively, without significant intergroup differences. Anti-PD-1 significantly improved RFS in patients with stage III/IV AM with KIT mutations (9.1 vs 5.0 months, p = 0.048) and ⩾4 lymph node metastases (10.5 vs 6.6 months, p = 0.036). Anti-PD-1 had significantly fewer adverse effects than HDI (60.4% vs 88.6%, p < 0.001), including fewer grades 3-4 events (4.6% vs 30.7%, p < 0.001). Adjuvant anti-PD-1 therapy provides RFS comparable to that of HDI in AM and CM, with a superior safety profile. Patients with AM harboring KIT mutations derive greater benefits from adjuvant anti-PD-1 therapy. How well do adjuvant anti-PD-1 therapy and high-dose interferon work for people with acral melanoma? A multicenter study Acral melanoma (AM) is one type of melanoma that grows on palms, soles, or subungual regions. Cutaneous melanoma (CM) is another type that grows on other parts of the skin. For CM, doctors often recommend anti-PD-1 therapy after surgery to reduce the risk of recurrence and metastasis. However, there’s no clear advice on what treatment to use after surgery for AM. We analyzed 511 patients (362 AM, 149 CM) treated with adjuvant anti-PD-1 therapy or high-dose interferon α-2b (HDI) between 2017 and 2023. The patients were divided into four groups: CM patients treated with anti-PD-1 (CM-PD-1), CM patients treated with HDI (CM-HDI), AM patients treated with anti-PD-1 (AM-PD-1), AM patients treated with HDI (AM-HDI). We found that AM patients had thicker tumors, more ulcers, and fewer changes to a gene called BRAF than CM patients. For both AM and CM patients, anti-PD-1 therapy and HDI kept the cancer away for similar lengths of time, and didn’t affect how long people lived much differently. But there was an exception: AM patients who had changes to a gene called KIT, or whose cancer had spread to 4 or more lymph nodes, stayed cancer-free longer when they used anti-PD-1 therapy. Also, anti-PD-1 therapy caused fewer side effects: 60.4% of people had side effects, compared to 88.6% of those who used HDI. Severe side effects were also less common—only 4.6% with PD-1 inhibitors, versus 30.7% with HDI.
使用 AI 将内容摘要翻译为中文，便于快速阅读
使用 AI 分析这篇文章的核心发现、关键要点和深度见解
由 DeepSeek AI 提供分析 · 首次使用需配置 API Key
arXiv · 2025-01-04
arXiv · 2023-06-01