title: Correlation between vitiligo occurrence and clinical benefit in advanced melanoma patients treated with nivolumab: A multi-institutional retrospective study.
abstract: Vitiligo is occasionally seen in melanoma patients. Although several studies indicate a correlation between vitiligo occurrence and clinical response in melanoma patients receiving immunotherapy, most studies have included heterogeneous patient and treatment settings. The aim of this study is to investigate the correlation between the occurrence of vitiligo and clinical benefit of nivolumab treatment in advanced melanoma patients. We retrospectively reviewed unresectable stage III or IV melanoma patients treated with nivolumab. Of 35 melanoma patients treated with nivolumab, 25.7% (9/35) developed vitiligo during treatment. The time from the start of nivolumab treatment to occurrence of vitiligo ranged 2-9 months (mean, 5.2). Of nine patients who developed vitiligo, two (22.2%) had a complete response to nivolumab and two (22.2%) had a partial response. The objective response rate was significantly higher in patients with vitiligo than in patients without vitiligo (4/9 [44.4%] vs 2/26 [7.7%]; P = 0.027). The mean time to vitiligo occurrence in patients achieving an objective response was significantly less than that in patients who showed no response (3.1 vs 6.8 months, P = 0.004). Vitiligo occurrence was significantly associated with prolonged progression-free and overall survival (hazard ratio, 0.24 and 0.16; 95% confidence interval, 0.11-0.55 and 0.03-0.79; P = 0.005, and 0.047, respectively). At the 20-week landmark analysis, however, vitiligo was not associated with a statistically significant overall survival benefit (P = 0.28). The occurrence of vitiligo during nivolumab treatment may be correlated with favorable clinical outcome.
authors: Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors: Yasuhiro
authors: Y
authors: Nakamura
authors: Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors: Ryota
authors: R
authors: Tanaka
authors: Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors: Yuri
authors: Y
authors: Asami
authors: Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors: Yukiko
authors: Y
authors: Teramoto
authors: Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors: Taichi
authors: T
authors: Imamura
authors: Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors: Sayuri
authors: S
authors: Sato
authors: Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors: Hiroshi
authors: H
authors: Maruyama
authors: Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors: Yasuhiro
authors: Y
authors: Fujisawa
authors: Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors: Taisuke
authors: T
authors: Matsuya
authors: Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors: Manabu
authors: M
authors: Fujimoto
authors: Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors: Akifumi
authors: A
authors: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D000077594:Nivolumab; D012189:Retrospective Studies; D016896:Treatment Outcome; D014820:Vitiligo / Q000209:etiology*
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000077594:Nivolumab
keywords: immune-related adverse events; melanoma; nivolumab; programmed death receptor-1; vitiligo