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Journal of Cancer Research and Clinical Oncology

Erschienen in:

30.09.2021 | Original Article – Clinical Oncology

Vitiligo-like leukoderma as an indicator of clinical response to immune checkpoint inhibitors in late-stage melanoma patients

verfasst von: Sofia Verkhovskaia, Francesca Romana Di Pietro, Simona Mastroeni, Maria Luigia Carbone, Damiano Abeni, Roberto Morese, Francesca Maria Morelli, Stefania D’Atri, Paolo Marchetti, Federica De Galitiis, Cristina Maria Failla, Cristina Fortes

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 9/2022

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Abstract

Purpose

Although development of immune checkpoint inhibitors has revolutionized the treatment of metastatic melanoma, more than a half of treated patients experience disease progression during therapy. Cases of spontaneous vitiligo-like leukoderma have been described in melanoma patients and have been associated with a favorable outcome. This vitiligo-like leukoderma can also appear in melanoma patients undergoing immune therapies such as immune checkpoint inhibitors. However, no consensus exists about the relationship between vitiligo-like leukoderma onset and improved overall survival. Our study investigates the possible association between the onset of vitiligo-like leukoderma during immune checkpoint inhibitor treatment and a better prognosis.

Methods

A non-concurrent cohort study was conducted by identifying retrospectively 280 patients who had inoperable or metastatic melanoma and had undergone immune therapy with checkpoint inhibitors in any line of treatment. Toxicities developed during therapy were evaluated.

Results

Among the 280 study participants, 50% developed at least one type of toxicity, and vitiligo-like leukoderma was observed in 43 patients (15.4%). In the multivariate Cox model, a protective effect for mortality was observed for patients with vitiligo-like leukoderma development (HR : 0.23; 95% CI 0.11–0.44, p < 0.0001). In a sub-group analysis comprising only cutaneous melanoma in first line of treatment (N = 153), occurrence of vitiligo-like leukoderma was also an independent predictor factor for duration of clinical benefits measured by time to the next treatment (HR: 0.17; 95% CI 0.06–0.44).

Conclusion

Our findings indicate that onset of vitiligo-like leukoderma during melanoma treatment could be a marker of favorable outcome in patients treated with immune checkpoint inhibitors.

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Titel: Vitiligo-like leukoderma as an indicator of clinical response to immune checkpoint inhibitors in late-stage melanoma patients
verfasst von: Sofia Verkhovskaia
Francesca Romana Di Pietro
Simona Mastroeni
Maria Luigia Carbone
Damiano Abeni
Roberto Morese
Francesca Maria Morelli
Stefania D’Atri
Paolo Marchetti
Federica De Galitiis
Cristina Maria Failla
Cristina Fortes
Publikationsdatum: 30.09.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 9/2022
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-021-03811-3

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Vitiligo-like leukoderma as an indicator of clinical response to immune checkpoint inhibitors in late-stage melanoma patients