• Paul Nathan, Paolo A Ascierto, John Haanen, Enrique Espinosa, Lev Demidov, Claus Garbe, Michele Guida, Paul Lorigan, Vanna Chiarion-Sileni, Helen Gogas, Michele Maio, Maria Teresa Fierro, Christoph Hoeller, Patrick Terheyden, Ralf Gutzmer, Tormod K Guren, Dimitrios Bafaloukos, Piotr Rutkowski, Ruth Plummer, Ashita Waterston, Martin Kaatz, Mario Mandala, Ivan Marquez-Rodas, Eva Muñoz-Couselo, Reinhard Dummer, Elena Grigoryeva, Tina C Young, and Dirk Schadendorf.
• Department of Medical Oncology, Mount Vernon Cancer Centre, London, United Kingdom. Electronic address: p.nathan@nhs.net.
• Eur. J. Cancer. 2019 Sep 1; 119: 168-178.

BackgroundNivolumab has been widely studied in non-acral cutaneous melanoma; however, limited data are available in other melanoma subtypes. We report outcomes by melanoma subtype in patients who received nivolumab after progression on prior ipilimumab.Patients And MethodsCheckMate 172 was a phase II, single-arm, open-label, multicentre study that evaluated nivolumab in patients with advanced melanoma who progressed on or after ipilimumab. Patients received 3 mg/kg of nivolumab, every 2 weeks for up to 2 years. The primary end-point was incidence of grade ≥3, treatment-related select adverse events (AEs).ResultsAmong 1008 treated patients, we report data on patients with non-acral cutaneous melanoma (n = 723 [71.7%]), ocular melanoma (n = 103 [10.2%]), mucosal melanoma (n = 63 [6.3%]), acral cutaneous melanoma (n = 55 [5.5%]) and other melanoma subtypes (n = 64 [6.3%]). There were no meaningful differences in the incidence of grade ≥3, treatment-related select AEs among melanoma subtypes or compared with the total population. No new safety signals emerged. At a minimum follow-up of 18 months, median overall survival was 25.3 months for non-acral cutaneous melanoma and 25.8 months for acral cutaneous melanoma, with 18-month overall survival rates of 57.5% and 59.0%, respectively. Median overall survival was 12.6 months for ocular melanoma and 11.5 months for mucosal melanoma, with 18-month overall survival rates of 34.8% and 31.5%, respectively.ConclusionsThe safety profile of nivolumab after ipilimumab is similar across melanoma subtypes. Compared with non-acral cutaneous melanoma, patients with acral cutaneous melanoma had similar survival outcomes, whereas those with ocular and mucosal melanoma had lower median overall survival. CLINICALTRIALS.Gov IdNCT02156804.Copyright © 2019 Elsevier Ltd. All rights reserved.

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