Melanoma of esophagus (ME) is a rare type of melanoma, accounting for <3% of cases. Patients with advanced melanoma of esophagus origin, tend to have lower response rates on traditional therapies. Thus, we report our experience with 11 patients with advanced esophageal melanoma who received PD-1 inhibitors.
A retrospective analysis of 77 patients with advanced ME were conducted from the database of Peking University Cancer Hospital between Jan 2008 and Sep 2017. We collected the clinical data and assessed objective response rates (ORR) and progression–free survival (PFS). The data cutoff date was Jan 1st 2018.
We identified the 77 patients were unresectable or metastatic esophageal melanomas. The Median age was 57, with 67.5% being male. 78% patients had history of esophagectomy and 64 patients had received prior systemic therapy. There were 8 (10.4%) patients harbored C-KIT mutations and 5 (6.5%) harbored BRAF. We divided the patients into 3 cohorts according to different treatments: Chemotherapy (C: 8 DTIC/26 TMZ/ 23 PTX; 57 cases), Targeted therapy (T: 6 imatinib/3 vemurafenib; 9 cases) or PD-1 inhibitors (P, 11 cases). The PFS were 3.0 and 4.2 months with limited ORR of 5.7% and 25.0% respectively for C and T cohort. In the P cohort, 7/11 patients (63.6%) achieved PR and other 3 remained SD > 4+ months. The PFS for the P cohort was 13.0+ months. Toxicities were as expected and were usually grade 1or 2.
Although this cohort of patients was small, it was the largest report for now. To our knowledge this is also the first report of outcomes of PD-1 inhibitors in advanced esophageal melanomas. The dramatic response appears to be an available option for patients with advanced esophageal melanomas.
Clinical trial identification
Legal entity responsible for the study
Beijing Cancer Hospital.
Has not received any funding.
All authors have declared no conflicts of interest.