LETTER TO THE EDITOR
No Overall Survival Difference in the Immunotherapy Era for Rare Subtypes of Melanoma
- 1Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- 2Istituto Europeo di Oncologia (IEO), Milan, Italy
- 3Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
We read with interest the article by Uprety et al. on the melanoma survival between contemporary periods depending on the approval time of immunotherapy . I want to congratulate the authors for this fruitful article and make some contributions.
In the study, it has been indicated that the immunotherapy era was significantly added benefits to overall survival (OS) for melanoma patients; however, the rare sites of melanoma should be included in these two contemporary groups. Unluckily, the patients with these relatively rare melanoma subtypes (acral lentiginous, uveal, and mucosal melanomas) which typically do not respond to the emerging immunotherapy that has been approved for the more common type of melanoma, and thus have worse overall survival rates  and attempting to reach enduring safe and effective responses in these high-risk subtypes of melanoma is one of the field's main challenges .
We searched for the distant rare subtypes of melanoma (Stage - 6th edition. Derived AJCC M, 6th ed (2004-2015) from Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database 3.8.9 version: Incidence - SEER Research Data, 18 Registries, Nov 2019 Sub (2000-2017), and follow-up. We revealed that there was no significant difference in survival between immunotherapy and non-immunotherapy era p = 0.31. Figure 1 Our findings give more attention to the clinician in practice with the rare melanoma subtypes in the era of immunotherapy.
FIGURE 1. Kaplan Meier–OS difference between rare subtypes of melanoma (p = 0.31). 1- Immunotherapy era. 2- non-immunotherapy era.
We strongly highlight effective clinical and preclinical studies toward these rare subtypes of melanoma, including the combination of immunotherapy and anti-vascular agents (NCT03955354, NCT03991975, NCT03602547), new immune checkpoint inhibitors (NCT02071940 with an anti-CSF1) and cell-based approaches (NCT01983748) [3, 4].
These authors have contributed equally to this work and share the first authorship.
Conflict of Interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
1. Uprety, D, Bista, A, Chennamadhavuni, A, Niroula, A, Jafri, SIM, Smith, A, et al. Survival trends among patients with metastatic melanoma in the pretargeted and the post-targeted era: a US population-based study. Melanoma Res (2018) 28(1):56–60. doi:10.1097/cmr.0000000000000394
2. Rodrigues, M, de Koning, L, Coupland, S, Jochemsen, A, Marais, R, Stern, M-H, et al. So close, yet so far: discrepancies between uveal and other melanomas. A position paper from um cure 2020. Cancers (2019) 11(7):1032. doi:10.3390/cancers11071032
Keywords: melanoma, SEER database, immunotherapy, survival, epidimiology
Citation: Safi M, Trapani D, Alradhi M, Shan X and Jiwei L (2021) No Overall Survival Difference in the Immunotherapy Era for Rare Subtypes of Melanoma. Pathol. Oncol. Res. 27:639004. doi: 10.3389/pore.2021.639004
Received: 08 December 2020; Accepted: 15 March 2021;
Published: 17 June 2021.
Edited by:József Tímár, Semmelweis University, Hungary
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