Cancer Immunology, Immunotherapy

, Volume 66, Issue 9, pp 1153–1162 | Cite as

The experience of immune checkpoint inhibitors in Chinese patients with metastatic melanoma: a retrospective case series

  • Xizhi Wen
  • Ya Ding
  • Jingjing Li
  • Jingjing Zhao
  • Ruiqing Peng
  • Dandan Li
  • Baoyan Zhu
  • Yao Wang
  • Xing Zhang
  • Xiaoshi ZhangEmail author
Original Article


Melanomas in Chinese patients show relatively higher rates of acral and mucosal types than in other populations. However, the efficacy of checkpoint inhibitor therapies against these melanoma subtypes is not well defined. We analyzed 52 patients treated with ipilimumab, pembrolizumab, or a combination of both to evaluate the efficacy and safety of checkpoint inhibitors in Chinese patients with advanced melanoma, particularly those with acral and mucosal types. The objective response rates (ORRs) were 0, 25, and 20% for ipilimumab, pembrolizumab, and pembrolizumab plus ipilimumab, respectively. Pembrolizumab contained therapy was as effective in acral and mucosal melanoma patients (ORR 26.7 and 20%, respectively) as in non-acral cutaneous melanoma patients (ORR 26.7%). Baseline lactate dehydrogenase levels and relative lymphocyte counts were independent prognostic factors for PFS and OS. The incidences of grade 3–4 adverse events were 14% in the two monotherapy groups and 30% in the combined therapy group. The most frequent adverse events were elevation of aminotransferase, skin toxicity, thyroid dysfunction, pyrexia, and fatigue. Treatment-related rash or vitiligo was associated with a better prognosis. In summary, pembrolizumab-based therapy resulted in meaningful efficacy and good tolerability in Chinese patients with melanoma, including those with acral and mucosal types.


Ipilimumab Pembrolizumab Chinese patients Acral melanoma Mucosal melanoma Biomarkers 



Spartate aminotransferase


Alanine aminotransferase


Chronic sun-derived




National Cancer Institute Common Terminology Criteria for Adverse Events


Disease control rate


Eastern Cooperative Group




Not reached


Overall survival


Objective response rate




Partial remission


Progression-free survival


Response evaluation criteria in solid tumors


Relative lymphocyte count


Relative eosinophil count


Stable disease


Upper limit of normal


Compliance with ethical standards


This study received support from the National Natural Science Foundation of China (Grant No. 81272341).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The institutional review board at our hospital approved this study.

Informed consent

All patients provided written informed consent for this study.

Supplementary material

262_2017_1989_MOESM1_ESM.pdf (729 kb)
Supplementary material 1 (PDF 729 KB)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Xizhi Wen
    • 1
  • Ya Ding
    • 1
  • Jingjing Li
    • 1
  • Jingjing Zhao
    • 1
  • Ruiqing Peng
    • 1
  • Dandan Li
    • 1
  • Baoyan Zhu
    • 1
  • Yao Wang
    • 1
  • Xing Zhang
    • 1
  • Xiaoshi Zhang
    • 1
    Email author
  1. 1.Biotherapy Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat-sen University Cancer CenterGuangzhouPeople’s Republic of China

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