Effect of paclitaxel/carboplatin salvage chemotherapy in noncutaneous versus cutaneous metastatic melanoma

Chang, Wonjin; Lee, Su Jin; Park, Silvia; Choi, Moon Ki; Hong, Jung Yong; Kim, Young Saing; Maeng, Chi Hoon; Jung, Hyun Ae; Kim, Sung-Min; Lee, Jeeyun

doi:10.1097/cmr.0b013e32835efd8d

Cited by 28 publications

(18 citation statements)

References 28 publications

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“…However, many series questioned the value of extensive, radical operations for mucosal tumors, which are associated with extremely high risk of systemic recurrence . Recent small studies have suggested a survival benefit for adjuvant chemotherapy in MM, although larger studies are needed to validate these findings . Our data indicate that patients with MM may not achieve optimal survival despite high rates of aggressive local resections and radiotherapy, and their associated morbidity.…”

Section: Discussionmentioning

confidence: 73%

Epidemiology and survival outcomes of ocular and mucosal melanomas: A population‐based analysis

Bishop

Olszewski

2013

Intl Journal of Cancer

163

135

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Extracutaneous melanomas are poorly characterized tumors that include ocular (OM), mucosal (MM) and leptomeningeal melanomas, often lacking standardized staging and treatment guidelines. We analyzed cases of cutaneous melanoma (CM, N 5 219,890), OM (N 5 7,069) and MM (N 5 2,755) of different anatomical origins, diagnosed between 1988 and 2010, recorded in the Surveillance Epidemiology and End Results (SEER) database. Relative survival was studied in patients grouped by summary stage classification (localized, regional or distant disease) and in multivariate models adjusting for varying distribution of baseline factors. Unlike in CM, the incidence rate in MM increased exponentially with age. Five-year relative survival was significantly worse for OM (78%) and for most mucosal sites (aggregate 34%, range 3-69%) compared with CM (89%). The differences between primary sites were particularly pronounced in localized disease, with a hazard ratio of 5.7 for OM, 4.3-9.0 for external genital or oral cavity MM and 19.8-90.4 for other mucosal locations. Melanomas of the pharynx, gastrointestinal, urinary tract and vagina had poor outcomes regardless of clinical stage. In contrast to CM, there was no evidence of improved survival in OM and MM during the study period. A substantial proportion of patients with operable OM or MM underwent radical organ resections (13-88% depending on site and stage) or perioperative radiotherapy (0-66%). In conclusion, extracutaneous melanomas have a markedly worse survival than CM and aggressive locoregional management appears to be insufficient for their control. Because of poor outcomes in MM, studies of systemic therapy are warranted regardless of the extent of disease at presentation.Extracutaneous melanomas (ECMs) are rare, aggressive cancers that encompass ocular, mucosal and leptomeningeal melanomas. Ocular (OM) and mucosal melanomas (MM) have incidence of less than 1 per 100,000 person-years, making accrual into prospective studies difficult. 1 Consequently, there are no evidence-based management guidelines for these subtypes. ECMs have been reported to occur in older patients, often at an advanced stage, and to have worse prognosis. 2,3 It is possible that mechanisms of carcinogenesis in ECM differ from those in cutaneous melanoma (CM), rendering currently used targeted therapies ineffective. 4 The objective of our study was to examine incidence, survival outcomes and locoregional treatment patterns of CM, OM and MM in the United States over the past two decades using a populationbased registry. Patients and Methods Data sourceThe Surveillance Epidemiology and End Results (SEER) program collects data on cancer incidence, treatment and outcomes from 18 United States (US) registries, currently representing 28% of the total US population. The registry mandates a 98% case ascertainment rate and conducts continuous quality assurance programs to secure completeness and consistency of coding. We extracted case listings and incidence rates from the November 2012 SEER submission files, coveri...

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Section: Discussionmentioning

confidence: 73%

Epidemiology and survival outcomes of ocular and mucosal melanomas: A population‐based analysis

Bishop

Olszewski

2013

Intl Journal of Cancer

163

135

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“…This classification, missing T1 and T2 stages, can be attributed to the aggressive local growth pattern of this tumor entity with irregular borders, melanosis, and in-transit metastases [9]. conventional chemotherapies have not so far shown any significant benefit [10][11][12].…”

Section: Introductionmentioning

confidence: 98%

Identification and clinical relevance of PD-L1 expression in primary mucosal malignant melanoma of the head and neck

Thierauf¹,

Veit²,

Affolter

et al. 2015

Melanoma Research

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Mucosal melanoma of the head and neck is a rare and aggressive tumor entity with a poor prognosis. The standard treatment is radical tumor resection, with or without adjuvant radiation, where conventional chemotherapies in advanced stage or recurrent diseases have shown little benefit. Overexpression of the programmed cell death ligand 1 (PD-L1) is a common feature in human cancer. Although PD-L1 is an acknowledged prognostic biomarker for dismal prognosis in other tumors of the head and neck, expression and clinical relevance of PD-L1 in mucosal melanoma have not been addressed so far. We assessed PD-L1 expression using immunohistochemical staining in 23 tumor samples from patients with primary mucosal melanoma and correlated expression status with clinicopathological and outcome data. Tumors were derived from the nasal cavity (43.5%), nasal sinuses (43.5%), and the conjunctiva (13%). All patients had undergone surgery; 39% of all patients received adjuvant radiation and 13% were administered systemic interferon therapy. The probability of 1- and 5-year overall survival was 87 and 34.8%, respectively. The mean overall survival was 51 months and the mean recurrence-free survival was 23 months. Immunohistochemical staining showed PD-L1 expression in 13% (3/23) of mucosal melanoma. In contrast, prominent PD-L1 staining was detected in 100% of tissue sections from a control group of cutaneous melanoma (n=9). PD-L1 expression in mucosal melanoma was not correlated with age, sex, nor anatomical localization of the tumor. Interestingly, patients with PD-L1-positive mucosal melanoma had a significantly longer recurrence-free survival (P=0.026). In contrast to cutaneous melanoma and some other malignancies, a relevant PD-L1 overexpression in mucosal melanoma could not be confirmed.

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“…The median PFS was 2.53 months in all patients, and 21.9% of them achieved PR. No significant difference was observed between MM patients and cutaneous melanoma patients, indicating that paclitaxel combined with carboplatin may also be a reasonable option for metastatic MM patients who have received multi-line treatment (189).…”

Section: Adjuvant Chemotherapymentioning

confidence: 94%

Chinese Guidelines on the Diagnosis and Treatment of Melanoma (2015 Edition)

et al. 2016

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Effect of paclitaxel/carboplatin salvage chemotherapy in noncutaneous versus cutaneous metastatic melanoma

Cited by 28 publications

References 28 publications

Epidemiology and survival outcomes of ocular and mucosal melanomas: A population‐based analysis

Epidemiology and survival outcomes of ocular and mucosal melanomas: A population‐based analysis

Identification and clinical relevance of PD-L1 expression in primary mucosal malignant melanoma of the head and neck

Chinese Guidelines on the Diagnosis and Treatment of Melanoma (2015 Edition)

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