Resectable Sinonasal Mucosal Melanoma in the Immunotherapy Era: Upfront Surgery vs. Neoadjuvant Therapy.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-02-05 DOI:10.1002/hed.28098

Aya F Salem, Melissa M Chen, Michelle D Williams, David M Swanson, Jennifer L McQuade, Rodabe N Amaria, Ehab Y Hanna, Andrew J Bishop, Ahsan S Farooqi, B Ashleigh Guadagnolo, Shirley Y Su, Devarati Mitra

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Abstract

Objective: We aim to evaluate outcomes for patients with resectable SNMM treated in the immunotherapy era.

Methods: Thirty-seven patients with resectable SNM were identified using our institutional database between 2016 and 2023.

Results: Patients receiving neoadjuvant Ipi/Nivo (46%, n = 17) were more likely to have disease involving the sinuses and/or the skull base (71% vs. 35%, p = 0.05). The overall response rate to Ipi/Nivo was 24%. Two-year LRFS from the start of therapy was 63%, and from the end of local therapy was 78%. Two-year PFS was 49%. The patients who received Ipi/Nivo with evidence of response (n = 4, 24%) had better PFS (2-year PFS 100% vs. 15%, p = 0.02) and LRFS (2-year LRFS 100% vs. 31%, p = 0.08).

Conclusions: Outcomes for resectable SNMM patients continue to be poor in the immunotherapy era. In the context of selection bias, neoadjuvant Ipi/Nivo was not associated with better outcomes in all-comers. However, those with evidence of response to Ipi/Nivo had better prognosis.

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免疫疗法时代的可切除鼻窦粘膜黑色素瘤：前期手术与新辅助治疗。

目的：我们旨在评估免疫治疗时代可切除SNMM患者的治疗效果。方法：在2016年至2023年期间，从我们的机构数据库中确定了37例可切除的SNM患者。结果：接受新辅助Ipi/Nivo的患者（46%,n = 17）更容易发生累及鼻窦和/或颅底的疾病（71%对35%，p = 0.05）。Ipi/Nivo的总有效率为24%。治疗开始后的两年LRFS为63%，局部治疗结束后的两年LRFS为78%。2年PFS为49%。接受Ipi/Nivo治疗且有缓解证据的患者（n = 4,24%）有更好的PFS（2年PFS 100% vs 15%， p = 0.02）和LRFS（2年LRFS 100% vs 31%， p = 0.08）。结论：在免疫治疗时代，可切除的SNMM患者的预后仍然很差。在选择偏倚的背景下，新辅助Ipi/Nivo与所有患者的更好结果无关。然而，有证据表明对Ipi/Nivo有反应的患者预后较好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.