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Effect of Radiotherapy Combined With Pembrolizumab on Local Tumor Control in Mucosal Melanoma Patients

Authors
 Hyun Ju Kim  ;  Jee Suk Chang  ;  Mi Ryung Roh  ;  Byung Ho Oh  ;  Kee-Yang Chung  ;  Sang Joon Shin  ;  Woong Sub Koom 
Citation
 Frontiers in Oncology, Vol.9 : 835, 2019 
Journal Title
FRONTIERS IN ONCOLOGY
Issue Date
2019
Keywords
adverse events ; immunotherapy ; local control ; melanoma ; radiotherapy
Abstract
Objective: Mucosal melanoma is an aggressive malignancy with a poor response to conventional therapies. The efficacy of radiotherapy (RT), especially combined with immune checkpoint inhibitors (ICIs), for this rare melanoma subtype remains unknown. We investigated the reciprocal effect of RT and ICI on mucosal melanoma patients. Materials and Methods: We identified 23 patients with 31 tumors who were treated with RT between July 2008 and February 2017. All patients received RT for primary or metastatic gross tumor mass with a median dose of 4 Gy per fraction (range 1.8-12 Gy). Eleven patients (14 lesions) were treated with RT alone, whereas 12 (17 lesions) were administered pembrolizumab combined with RT (ICI+RT group). The local control (LC) and adverse event (AE) rates were compared between the groups. Eight patients with metastatic mucosal melanoma treated with ICI alone during the same study period were included as a comparison group. Results: The median follow-up period was 17.4 (range 3.7-95.2) months. The target lesion control rate at 1-year was significantly higher in the ICI+RT group than in the RT-alone group or ICI-alone group (94.1% vs. 57.1% vs. 25%; P < 0.05). No abscopal effect was observed in our cohort. Treatment-related AEs were not significantly increased in the combined treatment group compared with the RT-alone group (P > 0.05). No grade ≥3 AEs occurred in the ICI+RT group. Conclusions: Besides RT acting as an immune adjuvant, ICI might have a radiosensitizing effect and may increase LC without severe toxicity. We have initiated a phase II study to determine the effects of RT in patients with melanoma undergoing anti-PD1 (NCT04017897).
Files in This Item:
T201903466.pdf Download
DOI
10.3389/fonc.2019.00835
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Roh, Mi Ryung(노미령) ORCID logo https://orcid.org/0000-0002-6285-2490
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Oh, Byung Ho(오병호) ORCID logo https://orcid.org/0000-0001-9575-5665
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Chung, Kee Yang(정기양) ORCID logo https://orcid.org/0000-0003-3257-0297
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/171397
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