Abstract 1173P
Background
Acral melanoma (AM) is the most common subtype of Chinese melanoma population, taking up over 50%-60%. Compared to cutaneous melanoma, AM is lack of frequent driven mutation like BRAF alternation which only occurs around 10%. Meanwhile, 10%-15% of AM can harbor NRAS mutation. This single-center retrospective study aims to investigate the survival impact of NRAS mutant status on Chinese AM after receiving radical surgery.
Methods
We retrospectively collected AM patients who received radical surgery in Fudan University Shanghai Center with confirmative genomic information from 2017 to 2021. Information of clinicopathologic factors and recurrence and survival outcomes was retrieved from patients document database of our hospital.
Results
Totally 317 patients were recruited in our study.170 (53.6%) were males and median age was 62 years old (range 26-89). 281 (88.6%) cases had primary lesion at lower extremity. The mean Breslow thickness were 3.9mm and ulceration rate was 65.9%. According to AJCC 8th staging system, there were 12% Stage I, 32.2% Stage II and 55.8% Stage III. Genomic alternation occured included 71(22.4%) NRAS, 36 (11.4%) BRAF, 33 (10.4%) KIT and the other 177 (55.8%) widetype of these three genes. No statistical difference was observed in most of clinicopathologic factors between NRAS-mut and NRAS-wt patients. However, NRAS-mut group had higher risk of nodal metastasis beyond 1st tier basin (42.3% vs 27.2, P<0.002).With median follow-up of 22 months, NRAS-mut patients had significantly worse relapse-free survival (RFS, P<0.0001) and overall survival (OS, P=0.010). Distant metastasis-free survival (DMFS) was also numerically reduced but not reached significance (P=0.074). Multivariate analysis showed NRAS mutation was an independent prognostic factors for both RFS (P=0.008) and OS (P=0.025).Among patients receiving adjuvant anti-PD1 monotherapy, median RFS time was significantly worse for NRAS-mut patients (9 months vs 26 months, P<0.0001).
Conclusions
In conclusion, AM harboring NRAS mutation had higher risk of relapse and death as well as reduced efficacy of adjuvant anti-PD1 monotherapy compared to NRAS-wt after radical surgery. NRAS mutation was an independent prognostic factor for resectable Chinese AM population.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
This research was funded by Shanghai Science and Technology Development Funds, grant number 9411951700; LinGang laboratory “Seeking Distinguished Young Scholars” project, grant number LG-QS-202205-11; National Natural Science Foundation of China, grant number 81802636.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1170P - Survival outcome prediction of primary melanoma tumours from histology images using deep learning
Presenter: Céline Bossard
Session: Poster session 13
1171P - Evaluation of the transcriptomic presence of tumor associated antigens (TAAs) from antibody drug conjugates (ADCs) and PD-L1 in melanoma: Options for new clinical opportunities
Presenter: Jorge Bartolome
Session: Poster session 13
1172P - Analysis of the microbiome of metastatic melanoma patients with complete response to immunotherapy
Presenter: Marin Golcic
Session: Poster session 13
1174P - Sex differences in advanced melanoma in Spain: Results from the prospective real-world study GEM 1801
Presenter: Eva Muñoz Couselo
Session: Poster session 13
1175P - Return to work after neoadjuvant versus adjuvant immunotherapy in stage III melanoma patients
Presenter: Judith Lijnsvelt
Session: Poster session 13
1176P - Planned drug holidays during immunotherapy in advanced and metastatic melanoma patients: A nation-wide study
Presenter: Anna Czarnecka
Session: Poster session 13
1177P - Assessment of tumour burden reduction per photography vs magnetic resonance imaging in patients with locally advanced basal cell carcinoma receiving sonidegib 200 mg
Presenter: Ralf Gutzmer
Session: Poster session 13
1178P - Melanoma incidence rises for pediatrics: 15-year nationwide retrospective cohort study in Korea (2004-2019)
Presenter: Jisu Oh
Session: Poster session 13
1179P - The underestimated skin cancer risk after liver transplantation: A meta-analysis of 147154 patients
Presenter: Amr Ehab El-Qushayri
Session: Poster session 13