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Survival and therapeutic response in patients with melanoma of unknown and known primary: a single-centre retrospective analysis

  • Clinical Report
  • Published:
European Journal of Dermatology

Abstract

Background

The survival of patients with melanoma of unknown primary (MUP) is proposed to be more favourable than that for melanoma of known primary (MKP). This may be due to an enhanced initial immune response in patients with MUP, which could also affect the efficacy of immunotherapy in advanced disease.

Objectives

The present study compared therapeutic outcome and survival in Stage III and IV MUP and MKP.

Results

Medical records of 67 MUP and 536 MKP patients were reviewed. Median overall survival (OS) in Stage III patients was 77 months versus 54 months in patients with MUP and MKP, respectively (p = 0.11). Median OS was prolonged in MUP patients receiving adjuvant first-line ipilimumab (p = 0.14). In contrast, OS tended to be more favourable in patients with MKP after palliative first-line ipilimumab treatment (p = 0.16). Yet, no statistically significant differences in OS were detected between the groups. Moreover, survival after anti-PD-1-antibody treatment was similar in patients with MUP and MKP.

Conclusion

Overall, we observed similar survival outcomes after immunotherapy in patients with MUP and MKP. These findings provide no evidence of difference in responsiveness to immunotherapy between patients with MUP and MKP.

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Author notes

  1. These authors contributed equally

Authors and Affiliations

  1. Department of Dermatology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland

    Sabine V. Ludwig, Phil F. Cheng, Joanna Mangana, Ralph Braun, Reinhard Dummer & Peter Koelblinger

  2. Department of Dermatology and Allergology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria

    Peter Koelblinger

Authors
  1. Sabine V. Ludwig
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  2. Phil F. Cheng
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  3. Joanna Mangana
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  4. Ralph Braun
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  5. Reinhard Dummer
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Corresponding author

Correspondence to Peter Koelblinger.

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Acknowledgements and disclosures

Acknowledgements: we thank our colleagues from the Comprehensive Cancer Center Zürich (CCCZ) for providing insight in the Giessener tumour documenting system (GTDS) and assisting in data collection. Conflicts of interest: Joanna Mangana has intermittent project-focused consultant or advisory relationships with Merck/Pfizer and Pierre Fabre and receives travel support from Merck Sharp & Dohme und Pierre Fabre outside of the submitted work. Reinhard Dummer has intermittent, project-focused consulting and/or advisory relationships with Novartis, Merck Sharp & Dhome (MSD), Bristol-Myers Squibb (BMS), Roche, Amgen, Takeda, Pierre Fabre, Sun Pharma, and Sanofi outside the submitted work. Peter Koelblinger has received a research fellowship grant from the European Academy of Dermatology and Venerology and honoraria for travel support and consulting/advisory roles from Roche, Bristol-Myers Squibb (BMS), Merck Sharp & Dome (MSD), Novartis and Amgen outside the submitted work. Sabine Ludwig, Ralph Braun and Phil Cheng have declared no conflicts of interest.

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Ludwig, S.V., Cheng, P.F., Mangana, J. et al. Survival and therapeutic response in patients with melanoma of unknown and known primary: a single-centre retrospective analysis. Eur J Dermatol 30, 699–709 (2020). https://doi.org/10.1684/ejd.2020.3929

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  • DOI: https://doi.org/10.1684/ejd.2020.3929

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