Vitiligo Predicts Improved Survival in Patients Receiving Immunotherapy for Stage III or IV Melanoma
In a systematic review and meta-analysis reported in the Journal of Clinical Oncology, Teulings et al found that development of vitiligo in patients receiving immunotherapy for stage III or IV melanoma was a significant predictor of improved progression-free and overall survival.
The study involved data from 5,737 patients in 137 studies on melanoma immunotherapy published between 1995 and 2013 that reported on autoimmune toxicity or vitiligo. The studies included a total of 139 treatment arms, including general immune stimulation in 11, vaccine in 84, antibody-based treatment in 28, and adoptive transfer in 16.
Improved Survival
The overall incidence of vitiligo was 3.4% (95% confidence interval = 2.5%–4.5%). In 27 studies reporting individual patient data, analysis adjusting for age and sex showed that development of vitiligo was associated with significantly improved progression-free survival (hazard ratio [HR] = 0.51, P = .005) and overall survival (HR = 0.25, P = .003).
The investigators concluded: “Although vitiligo occurs only in a low percentage of patients with melanoma treated with immunotherapy, our findings suggest clear survival benefit in these patients. Awareness of vitiligo induction in patients with melanoma is important as an indicator of robust antimelanoma immunity and associated improved survival.”
Hansje-Eva Teulings, MD, of University of Amsterdam, is the corresponding author for the Journal of Clinical Oncology article.
The study was supported by the Dutch Cancer Society. For full disclosures of the study authors, visit jco.ascopubs.org.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
