Journal of Clinical and Aesthetic Dermatology • Hot Topics in Melanoma November 2024 • News & Trends

NEW PROSPECTIVE, MULTICENTER STUDY PRESENTED AT SMR DEMONSTRATES CASTLE BIOSCIENCES’ DECISIONDX®-MELANOMA TEST PROVIDES SIGNIFICANT RISK PREDICTION FOR PATIENTS WITH CUTANEOUS MELANOMA, ADDING VALUE TO CURRENT STAGE-BASED TREATMENT PATHWAY DECISIONS

Research presented at the 21st International Congress of the Society for Melanoma Research showed that 31-gene expression profile (GEP) testing in patients with cutaneous melanoma significantly improved the prognostic value of American Joint Committee on Cancer (AJCC) staging. Class 1A (lowest risk) results were associated with significantly superior recurrence-free survival, compared to Class 1B/2A (intermediate risk) and Class 2B (highest risk) results.

IMMUNOTHERAPY COMBINATION MIGHT IMPROVE LONG-TERM SURVIVAL IN PATIENTS WITH METASTATIC MELANOMA

Among 945 patients with metastatic melanoma who received nivolumab plus ipilimumab, 50 percent of patients had 10-year or greater melanoma-free survival, according to a study published in NEJM. No new safety signals were reported at 10 years. Researchers observed that patients without disease progression had a high rate of melanoma-specific survival (MSS).

Comparing cases of head and neck melanoma (n=3,007) and melanoma at other locations (n=10,637), researchers found that the former had significantly greater median Breslow thickness and ulceration rates and affected significantly more older patients. Patients with head and neck melanoma faced significantly worse locoregional control and distant metastasis-free survival, compared to melanoma at other sites. However, among patients who received immune checkpoint inhibitor therapy, those with Stage IV head and neck melanoma experienced superior MSS and overall survival (OS), compared to Stage IV disease at other sites.

FIRST MELANOMA HISTORY IS RISK FACTOR FOR SUBSEQUENT DIAGNOSES REGARDLESS OF RACE

Researchers found that White individuals had a higher incidence of first and second primary melanoma, compared to individuals of other races and ethnicities. Relative risk of second primary melanoma was highest in Black individuals (standardized incidence ratio [SIR]: 264.39), followed by Asian/Pacific Islander individuals (SIR: 196.68). The SIRs for Hispanic and American Indian/Alaska Native subjects were 62.71 and 48.47, respectively. White subjects had the lowest SIR (11.63) but the highest absolute number of excess second melanomas.

A Phase Ib trial showed that IMA203, a T-cell receptor-T therapy, had an objective response rate of 54 percent among 28 patients with pretreated melanoma. Most patients had cutaneous (n=13) or uveal (n=12) melanoma. Median progressionfree survival was six months, and cytopenias were the most frequently reported adverse events in the Phase Ia/b trials.

RESEARCH BITE—Increased myositis and possible myocarditis in patients with melanoma treated with immune checkpoint inhibitors in the COVID-19 era

In this single-center, retrospective study, Gradone et al compared the incidence of immune checkpoint inhibitor (ICI)-induced myositis and myocarditis among patients with Stage III/IV melanoma treated in September 2014 to October 2019 (pre-COVID-19; n=366) and November 2019 to December 2021 (post- COVID-19; n=246). There were zero cases of ICI-mediated myocarditis in the pre-COVID-19 era, compared to 10 cases (4.1%) post-COVID-19. Furthermore, only two patients (0.55%) developed ICI-mediated myositis before the COVID-19 era, compared to 10 patients (4.1%) during the COVID-19 era. The differences were significant for both myocarditis and myositis.

Source: Gradone AL, Ma VT, Vasbinder A, et al. Increased myositis and possible myocarditis in melanoma patients treated with immune checkpoint inhibitors in the COVID-19 era. Cancer Immunol Immunother. 2024;73(12):259.