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    International multicenter study of clinical outcomes of sinonasal melanoma shows survival benefit for patients treated with immune checkpoint inhibitors and potential improvements to the current TNM staging system

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    Authors
    Lechner, M.
    Takahashi, Y.
    Turri-Zanoni, M.
    Ferrari, M.
    Liu, J.
    Counsell, N.
    Mattavelli, D.
    Rampinelli, V.
    Vermi, W.
    Lombardi, D.
    Saade, R.
    Park, K. W.
    Schartinger, V. H.
    Franchi, A.
    Facco, C.
    Sessa, F.
    Battocchio, S.
    Fenton, T. R.
    Vaz, F. M.
    O'Flynn, P.
    Howard, D.
    Stimpson, P.
    Wang, S.
    Hannan, S. A.
    Unadkat, S.
    Hughes, J.
    Dwivedi, R.
    Forde, C. T.
    Randhawa, P.
    Gane, S.
    Joseph, J.
    Andrews, P. J.
    Dave, M.
    Fleming, J. C.
    Thomson, David J
    Zhu, T. Y.
    Teschendorff, A.
    Royle, G.
    Steele, C.
    Jimenez, J. E.
    Laco, J.
    Wang, E. W.
    Snyderman, C.
    Lacy, P. D.
    Woods, R.
    O'Neill, J. P.
    Saraswathula, A.
    Kaur, R. P.
    Zhao, T. N.
    Ramanathan, M.
    Gallia, G. L.
    London, N. R.
    Le, Q. T.
    West, R. B.
    Patel, Z. M.
    Nayak, J. V.
    Hwang, P. H.
    Hermsen, M.
    Llorente, J.
    Facchetti, F.
    Nicolai, P.
    Bossi, P.
    Castelnuovo, P.
    Jay, A.
    Carnell, D.
    Forster, M. D.
    Bell, D. M.
    Lund, V. J.
    Hanna, E. Y.
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    Affiliation
    UCL Cancer Institute, University College London, London, UK
    Issue Date
    2022
    
    Metadata
    Show full item record
    Abstract
    Objectives Sinonasal mucosal melanoma (SNMM) is an extremely rare and challenging sinonasal malignancy with a poor prognosis. Standard treatment involves complete surgical resection, but the role of adjuvant therapy remains unclear. Crucially, our understanding of its clinical presentation, course, and optimal treatment remains limited, and few advancements in improving its management have been made in the recent past. Methods We conducted an international multicenter retrospective analysis of 505 SNMM cases from 11 institutions across the United States, United Kingdom, Ireland, and continental Europe. Data on clinical presentation, diagnosis, treatment, and clinical outcomes were assessed. Results One-, three-, and five-year recurrence-free and overall survival were 61.4, 30.6, and 22.0%, and 77.6, 49.2, and 38.3%, respectively. Compared with disease confined to the nasal cavity, sinus involvement confers significantly worse survival; based on this, further stratifying the T3 stage was highly prognostic (p < 0.001) with implications for a potential modification to the current TNM staging system. There was a statistically significant survival benefit for patients who received adjuvant radiotherapy, compared with those who underwent surgery alone (hazard ratio [HR] = 0.74, 95% confidence interval [CI]: 0.57–0.96, p = 0.021). Immune checkpoint blockade for the management of recurrent or persistent disease, with or without distant metastasis, conferred longer survival (HR = 0.50, 95% CI: 0.25–1.00, p = 0.036). Conclusions We present findings from the largest cohort of SNMM reported to date. We demonstrate the potential utility of further stratifying the T3 stage by sinus involvement and present promising data on the benefit of immune checkpoint inhibitors for recurrent, persistent, or metastatic disease with implications for future clinical trials in this field.
    Citation
    Lechner M, Takahashi Y, Turri-Zanoni M, Ferrari M, Liu J, Counsell N, et al. International Multicenter Study of Clinical Outcomes of Sinonasal Melanoma Shows Survival Benefit for Patients Treated with Immune Checkpoint Inhibitors and Potential Improvements to the Current TNM Staging System. Journal of Neurological Surgery Part B-Skull Base. PubMed PMID: WOS:000822748800001.
    Journal
    Journal of Neurological Surgery Part B-shull Base
    URI
    http://hdl.handle.net/10541/625490
    DOI
    10.1055/s-0042-1750178
    Additional Links
    https://dx.doi.org/10.1055/s-0042-1750178
    Type
    Meetings and Proceedings
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1055/s-0042-1750178
    Scopus Count
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