Checkpoint inhibition for advanced mucosal melanoma.
BACKGROUND
Whereas anti-PD-1 therapy has demonstrated a significant and durable response against advanced cutaneous melanoma, conventional chemotherapies have shown only minor benefit against advanced mucosal melanoma.


OBJECTIVE
To investigate the efficacy of anti-PD-1 therapy in a small cohort of patients with mucosal melanoma of the head and neck.


METHODS
We analysed five patients with mucosal melanoma of the head and neck who received nivolumab or pembrolizumab, at an advanced stage. Expression of PD-L1 and PD-1 in all tumour samples was evaluated immunohistochemically.


RESULTS
All patients received at least two cycles of nivolumab or pembrolizumab. The most severe adverse events were categorised as CTCAE (common terminology criteria for adverse events) Grade 2. All patients showed progressive disease after restaging at three and six months, and no partial or complete response was observed. Immunohistochemical staining demonstrated PD-L1 expression in less than 5% of tumour cells.


CONCLUSIONS
Systemic therapy with either nivolumab or pembrolizumab showed no clinical response, however, tumour progression was identified in all patients using Response Evaluation Criteria In Solid Tumors (RECIST) v1.1 and immune-related response criteria (irRC) to evaluate tumour response.
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Ulm, Frauensteige 12, 89075 Ulm, Germany.
Julia
J
Thierauf
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Ulm, Frauensteige 12, 89075 Ulm, Germany.
Johannes A
JA
Veit
Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), Heidelberg, Im Neuenheimer Feld 280, 69121 Heidelberg, Germany, Section Experimental and Translational Head and Neck Oncology, Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Jochen
J
Hess
Department of Dermatology, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Nicolai
N
Treiber
Department of Diagnostic and Interventional Radiology, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm Germany.
Catharina
C
Lisson
Institute of Pathology, University Medical Center Ulm, Albert-Einstein-Allee 23, 89081, Ulm Germany.
Stephanie E
SE
Weissinger
Institute of Hematology, Oncology and infectious diseases, Alb-Fils-Kliniken, Göppingen, Eichertstrasse 3, 73035 Göppingen, Germany.
Martin
M
Bommer
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Ulm, Frauensteige 12, 89075 Ulm, Germany.
Thomas K
TK
Hoffmann
D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D060890:B7-H1 Antigen / Q000032:analysis; D059447:Cell Cycle Checkpoints / Q000187:drug effects; D018450:Disease Progression; D005260:Female; D006801:Humans; D008545:Melanoma / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D009092:Mucous Membrane; D000077594:Nivolumab; D009669:Nose Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D010255:Paranasal Sinus Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D061026:Programmed Cell Death 1 Receptor / Q000032:analysis / Q000037:antagonists & inhibitors*; D066066:Response Evaluation Criteria in Solid Tumors; D012189:Retrospective Studies; D017211:Treatment Failure
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D060890:B7-H1 Antigen; C423236:CD274 protein, human; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor; D000077594:Nivolumab; C582435:pembrolizumab
PD-1; anti-PD-1; head and neck; mucosal melanoma; nivolumab; pembrolizumab