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European Archives of Oto-Rhino-Laryngology
Published in: European Archives of Oto-Rhino-Laryngology 9/2023

Open Access 05-06-2023 | Mucosal Melanoma | Head and Neck

Multimodal treatment and immune checkpoint inhibition in sinonasal mucosal melanoma: real-world data of a retrospective, single-center study

Authors: Agmal Scherzad, Manuel Stöth, Till J. Meyer, Lukas Haug, Thomas Gehrke, Bastian Schilling, Svenja Meierjohann, Matthias Scheich, Rudolf Hagen, Anja Gesierich, Stephan Hackenberg

Published in: European Archives of Oto-Rhino-Laryngology | Issue 9/2023

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Abstract

Purpose

Local failure and distant metastases occur frequently in sinonasal mucosal melanoma (SNMM). Response rates to chemotherapy are low and targetable mutations are rarely detected. However, there is increasing data indicating efficacy of immune checkpoint inhibition (ICI). The aim of this retrospective monocenter study was to assess the mutational landscape and to evaluate the outcome of surgical treatment and ICI in SNMM in a real-world setting.

Methods

Thirty-eight SNMM patients being treated between 1999 and 2020 at our institution were retrospectively reviewed. Survival curves were generated according to Kaplan–Meier and compared by the log-rank test.

Results

Local failure was seen in 60% of patients treated in a curative intent. Overall, 24% of all patients suffered from regional and 66% from distant metastases. Next generation sequencing revealed mutations of BRAF, NRAS and KRAS. One out of three patients treated with a primary ICI showed a complete response (CR) and two showed progressive disease. Eleven patients received ICI as a palliative treatment. CR could be observed in three patients and stable disease in one patient. In the whole study population, the 5-year overall survival rate (OS) was 26%. OS was better for patients who received ICI during the course of disease.

Conclusions

Recurrences and distant metastases are frequent in SNMM. Durable CR could be observed after primary and palliative ICI. Therefore, ICI in a palliative, adjuvant or even neoadjuvant setting might play a promising role in SNMM therapy while targetable mutations are rarely detected.
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Metadata
Title
Multimodal treatment and immune checkpoint inhibition in sinonasal mucosal melanoma: real-world data of a retrospective, single-center study
Authors
Agmal Scherzad
Manuel Stöth
Till J. Meyer
Lukas Haug
Thomas Gehrke
Bastian Schilling
Svenja Meierjohann
Matthias Scheich
Rudolf Hagen
Anja Gesierich
Stephan Hackenberg
Publication date
05-06-2023
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 9/2023
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-023-08015-8

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