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Chemotherapy in combination with anti-PD-1 agents as adjuvant therapy for high-risk oral mucosal melanoma

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Background

Adjuvant therapy plays a critical role in the treatment of oral mucosal melanoma (OMM). Anti-programmed cell death-1 (PD-1) agents are recommended as front-line therapy for metastatic melanoma, but their efficacy as adjuvant therapy for high-risk OMM remains unclear.

Patients and methods

A single-center, retrospective cohort study was conducted in 193 nodular-type oral mucosal melanoma (NOMM) patients who received chemotherapy alone or in combination with high-dose interferon-α2b (HDI) or anti-PD-1 agents as adjuvant therapy. Multivariate analysis was performed to identify significant prognostic factors for the 2-year overall survival (OS) and progression-free survival (PFS).

Results

Tumor thickness, ulceration and invasion level were found to be independent prognostic factors for both 2-year OS and PFS, while T-stage was only associated with OS. The 2-year OS and PFS were 43.5% and 10.9% in patients who received only chemotherapy. In comparison, the 2-year OS was improved, albeit not significantly (47.4%; p > 0.05), and PFS was significantly improved (43.6%; p = 0.0028) in patients who received chemotherapy plus HDI; and both 2-year OS (71.0%; p = 0.0118) and PFS (53.6%; p = 0.0001) were significantly improved in patients received chemotherapy plus anti-PD-1. The serious adverse event (SAE) (p < 0.0001) and discontinued treatment due to SAE (p < 0.0001) were significantly lower in patients who received anti-PD-1 than in patients who received HDI.

Conclusions

Invasion level and tumor thickness are independent prognostic factors for NOMM. Chemotherapy plus anti-PD-1 agents seem to be the adjuvant therapy of choice for NOMM, as it is safer and more tolerable than HDI and, more importantly, it can significantly improve the OS and PFS.

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Abbreviations

OMM:

Oral mucosal melanoma

OS:

Overall survival

NOMM:

Nodular oral mucosal melanoma

CSCO:

Chinese Society of Clinical Oncology

NCCN:

National Comprehensive Cancer Network

HDI:

High-dose interferon-α2b

PD-1:

Programmed cell death-1

CLN:

Cervical lymph nodes

ECOG:

Eastern Cooperative Oncology Group

PS:

Performance status

CT:

Computed tomography

MRI:

Magnetic resonance imaging

PFS:

Progression free-survival

CM:

Cutaneous melanoma

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Funding

This work was supported by Fundamental research program funding of Ninth People's Hospital affiliated with Shanghai Jiao Tong University School of Medicine [No. JYZZ073].

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Author notes

  1. Joint first author: Yunteng Wu, Dongliang Wei contribute equally to this study.

Authors and Affiliations

  1. Department of Oral and Maxillofacial -Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, 200011, Shanghai, People’s Republic of China

    Yunteng Wu, Dongliang Wei, Guoxin Ren & Wei Guo

  2. College of Stomatology, Shanghai Jiao Tong University, 200011, Shanghai, People’s Republic of China

    Yunteng Wu, Dongliang Wei, Guoxin Ren & Wei Guo

  3. National Center for Stomatology, 200011, Shanghai, People’s Republic of China

    Yunteng Wu, Dongliang Wei, Guoxin Ren & Wei Guo

  4. National Clinical Research Center for Oral Diseases, 200011, Shanghai, People’s Republic of China

    Yunteng Wu, Dongliang Wei, Guoxin Ren & Wei Guo

  5. Shanghai Key Laboratory of Stomatology, 639 Zhi Zao Ju Road, 200011, Shanghai, People’s Republic of China

    Yunteng Wu, Dongliang Wei, Guoxin Ren & Wei Guo

Authors
  1. Yunteng Wu
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  2. Dongliang Wei
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Corresponding authors

Correspondence to Guoxin Ren or Wei Guo.

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The authors have declared no conflicts of interest.

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This research study was conducted retrospectively from data obtained for clinical purposes.

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Wu, Y., Wei, D., Ren, G. et al. Chemotherapy in combination with anti-PD-1 agents as adjuvant therapy for high-risk oral mucosal melanoma. J Cancer Res Clin Oncol 149, 2293–2300 (2023). https://doi.org/10.1007/s00432-022-04090-2

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  • DOI: https://doi.org/10.1007/s00432-022-04090-2

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