Impact of Hematologic Malignancies on Treatment Outcomes for Patients With Advanced Melanoma

A comprehensive analysis found patients with hematologic malignancies and advanced melanoma who were treated with immune checkpoint inhibitors experienced significantly worse melanoma-related outcomes compared to patients without hematologic malignancies.

While patients with hematologic malignancies are at a higher risk for the development of solid tumors such as malignant melanomas, Oliver J Van Not, MD, University Medical Centre Utrecht, Netherlands, and colleagues explained “little is known about the influence of [hematologic malignancies] on the response to anti-PD-1 treatment for solid tumors such as advanced melanoma.”

The study analyzed data from the prospective nationwide Dutch Melanoma Treatment Registry and included a total of 4638 advanced melanoma patients treated with first-line anti-PD-1 monotherapy (n = 1763), ipilimumab-nivolumab (n = 800), or BRAF(/MEK) inhibitors (n = 2075) between 2015 and 2021. Among these patients, concurrent hematological malignancies were present in 46 patients in the anti-PD1 cohort, 11 in the ipilimumab-nivolumab cohort, and 43 in the BRAF(/MEK)-inhibitor cohort.

In the anti-PD-1 cohort, the median progression-free survival was 2.8 months for patients with hematologic malignancies vs 9.9 months for patients without hematologic malignancies (P = .01). Additionally, melanoma-specific survival was 41.2 months for patients with hematologic malignancies and 58.1 months for patients without hematologic malignancies (P = .00086). In multivariable analysis, the presence of hematological malignancies was associated with higher risk of melanoma progression (adjusted hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.15 to 2.29; P = .006) and melanoma-related death (adjusted HR, 1.74; 95% CI, 1.09 to 2.78; P = .02).

Dr Van Not et al, concluded that the trial’s findings “stress the importance of studies analyzing rare patient subgroups not represented in clinical trials, helping clinicians inform these patients of their chances of response and long-term survival.”

Source:

Van Not OJ, van den Eertwegh AJM, Haanen JB, et al. Response to checkpoint inhibition and targeted therapy in melanoma patients with concurrent haematological malignancies. Eur J Cancer. Published online: March 16, 2023. doi:10.1016/j.ejca.2023.03.009