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. 2023 Jul;6(7):e1825.
doi: 10.1002/cnr2.1825. Epub 2023 Apr 28.

Efficacy of immune checkpoint inhibitor treatment for head and neck mucosal melanoma recurrence in patients treated with carbon-ion radiotherapy

Atsushi Musha  1   2 , Nobuteru Kubo  1 , Hidemasa Kawamura  1 , Naoko Okano  1 , Hiro Sato  1 , Kohei Okada  1 , Kento Tomizawa  1 , Norichika Ota  1 , Akiko Adachi  1 , Masato Shino  3 , Osamu Nikkuni  3 , Shota Ida  3 , Katsuyuki Shirai  1   4 , Jun-Ichi Saitoh  1   5 , Satoshi Yokoo  2 , Kazuaki Chikamatsu  3 , Tatsuya Ohno  1
Affiliations

Efficacy of immune checkpoint inhibitor treatment for head and neck mucosal melanoma recurrence in patients treated with carbon-ion radiotherapy

Atsushi Musha et al. Cancer Rep (Hoboken). 2023 Jul.

Abstract

Background: Carbon-ion radiotherapy (C-ion RT) is effective for head and neck mucosal melanoma (HN-MM), including radioresistant mucosal melanoma. Melanoma also responds effectively to immune checkpoint inhibitors (ICIs). Data on the efficacy and safety of ICIs for HN-MM are insufficient.

Aims: To analyze the efficacy and safety of ICI salvage therapy in patients with HN-MM recurrence after C-ion RT.

Methods and results: This retrospective study analyzed the medical records of 52 patients with HN-MM treated with C-ion RT between 2012 and 2020. A dose of 57.6 or 64.0 Gy (relative biological effectiveness) was provided in 16 fractions. The primary endpoint was 3-year overall survival (OS) rate. The median follow-up time was 26.8 months for all patients. A total of 29 patients had local recurrence or distant metastasis, and 16 patients who received ICI therapy. The 3-year OS rate in the ICI group (n = 16) and best supportive care group (n = 13) were 53.8% and 0.0%, respectively (p = 0.837); the difference was not statistically significant. There were no deaths after 1 year among patients who underwent ICI therapy. No adverse events associated with C-ion RT were related to or exacerbated by ICI.

Conclusion: ICI salvage therapy is effective and safe for patients with HN-MM recurrence after C-ion RT.

Keywords: chemotherapy; melanoma; radiotherapy; survival.

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Conflict of interest statement

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Figures

FIGURE 1
FIGURE 1
Flow chart of patients with mucosal malignant melanoma treated with carbon‐ion radiotherapy.
FIGURE 2
FIGURE 2
OS, LC, and PFS curves of patients with mucosal malignant melanoma treated with carbon‐ion radiotherapy. (A) The 3‐year OS rate for all patients (n = 52) was 64.3%. (B) The 3‐year LC rate for all patients (n = 52) was 86.3%. (C) The 3‐year PFS rate for all patients (n = 52) was 31.1%. LC, local control; OS, overall survival; PFS, progression‐free survival.
FIGURE 3
FIGURE 3
OS curve of patients with mucosal malignant melanoma treated with C‐ion RT with or without ICIs. (A) ICI agents were approved for treating melanoma in 2014 in Japan. The patients (n = 52) were divided into two groups based on whether they had been diagnosed before 2014 (n = 8) or after 2014 (n = 44). The 3‐year OS rates of those diagnosed before 2014 (dotted line) and those diagnosed after 2014 (straight line) were 0.0% and 76.4%, respectively (p = .000) (B) The 3‐year OS rates in the ICI group (n = 16) (straight line) and BSC group (n = 13) (dotted line) were 53.8% and 0.0%, respectively (p = 0.482). This is the OS after the diagnosis of recurrence (any site) and treatment with C‐ion RT. BSC, best supportive care; C‐ion RT, carbon‐ion radiotherapy; ICI, immune checkpoint inhibitor; OS, overall survival.
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