Single Institution Experience with Immune Checkpoint Inhibitors in Vulvar and Vaginal Melanomas.

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Obstetrics and Gynecology International Pub Date : 2024-08-13 eCollection Date: 2024-01-01 DOI:10.1155/2024/7327692
Amrita Ladwa, Omar Elghawy, Varinder Kaur
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Abstract

Objectives: This study aimed to report clinical outcomes of patients with vaginal melanoma (VaM) or vulvar melanoma (VuM) who were treated with immune checkpoint inhibitors (ICI) and discuss the development of immune-related adverse events (irAE).

Materials and methods: This is a retrospective case series of patients diagnosed with VaM or VuM between July 2011 and September 2022 at the University of Virginia, Emily Couric Clinical Cancer Center. Patient demographics, disease characteristics, treatment outcomes, and adverse events were abstracted. The primary outcome was incidence of irAE.

Results: Eight patients were included in this study, four with VaM and four with VuM. Most (n = 6) had local or regional disease at first presentation, and 25% (n = 2) presented with distant metastasis. All patients received a CTLA-4 inhibitor and 75% (n = 6) received PD-1 inhibitor alone or in combination with a CTLA-4 inhibitor. Most (75%, n = 6) patients experienced irAE. Of those who had irAE, 83% (n = 5) required therapy interruption or discontinuation. Most (66%, n = 4) underwent ICI rechallenge of which 75% (n = 3) experienced subsequent irAE. Of all patients in the series, 75% of patients (n = 6) had partial or complete response to ICI.

Conclusion: This series is the first to detail incidence of irAEs and ICI rechallenges in vulvovaginal melanoma. Our findings indicate that while ICIs are effective, their use is associated with significant irAE development. Rechallenge of ICI after irAE is feasible but associated with risk of recurrent/new irAE. Further studies are needed to better quantify this risk.

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免疫检查点抑制剂治疗外阴和阴道黑色素瘤的单机构经验。
研究目的本研究旨在报告接受免疫检查点抑制剂(ICI)治疗的阴道黑色素瘤(VaM)或外阴黑色素瘤(VuM)患者的临床结果,并讨论免疫相关不良事件(irAE)的发生情况:这是一项回顾性病例系列研究,研究对象是2011年7月至2022年9月期间在弗吉尼亚大学艾米丽-库里克临床癌症中心确诊为VaM或VuM的患者。研究人员收集了患者的人口统计学资料、疾病特征、治疗结果和不良事件。主要结果是虹膜不良事件的发生率:本研究共纳入了八名患者,其中四人患有VaM,四人患有VuM。大多数患者(6 例)首次发病时为局部或区域性疾病,25% 的患者(2 例)出现远处转移。所有患者都接受了CTLA-4抑制剂治疗,75%的患者(6人)接受了PD-1抑制剂单独治疗或与CTLA-4抑制剂联合治疗。大多数患者(75%,n = 6)都出现了 irAE。在出现 irAE 的患者中,83%(5 人)需要中断或中止治疗。大多数患者(66%,n = 4)接受了 ICI 再挑战,其中 75% (n = 3)随后出现了 irAE。在该系列的所有患者中,75%的患者(6 例)对 ICI 有部分或完全反应:该系列研究首次详细介绍了外阴阴道黑色素瘤的虹膜AE和ICI再挑战发生率。我们的研究结果表明,虽然 ICIs 疗效显著,但使用 ICIs 会导致严重的虹膜异位症。在发生虹膜睫状体异常后重新挑战 ICI 是可行的,但与复发/新的虹膜睫状体异常风险相关。需要进一步研究以更好地量化这一风险。
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来源期刊
Obstetrics and Gynecology International
Obstetrics and Gynecology International OBSTETRICS & GYNECOLOGY-
CiteScore
3.60
自引率
0.00%
发文量
26
审稿时长
19 weeks
期刊介绍: Obstetrics and Gynecology International is a peer-reviewed, Open Access journal that aims to provide a forum for scientists and clinical professionals working in obstetrics and gynecology. The journal publishes original research articles, review articles, and clinical studies related to obstetrics, maternal-fetal medicine, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine and infertility, reproductive endocrinology, and sexual medicine.
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