Vitiligo-Like Depigmentation During Immunotherapy Associated with Improved Survival

Source: Skin Cancer Advisor, February 2015

the Cancer Therapy Advisor take:

According to a new study published in the Journal of Clinical Oncology, researchers in the Netherlands have found that although vitiligo-like depigmentation occurs only in a small number of patients with melanoma treated with immunotherapy, there is an evident survival benefit in these patients.

Vitiligo-like depigmentation in patients with melanoma was thought to be associated with more favorable clinical outcomes. Therefore, researchers sought to determine the cumulative incidence of vitiligo-like depigmentation and the prognostic value of vitiligo development on survival in patients with stage III to IV melanoma treated with immunotherapy.

Researchers identified 139 studies that included 139 treatment arms. Of those, 11 studied general immune stimulation, 84 studied vaccines, 28 were antibody-based, and 16 studied adoptive cell transfer. The studies included a total of 5,737 patients. Results showed the overall cumulative incidence of vitiligo was 3.4% (95% CI: 2.5 – 4.5%).

Researchers also found that vitiligo development was associated with progression-free survival (HR = 0.51; 95% CI: 0.32 – 0.82; P < 0.005) and overall survival (HR = 0.25; 95% CI: 0.10 – 0.61; P < 0.003).

The findings suggest that patients who developed vitiligo had two to four times less risk of disease progression and death compared with those who did not develop vitiligo.

The authors conducted a systematic review of patients with stage III to IV melanoma treated with immunotherapy to determine the cumulative incidence of vitiligo-like depigmentation and the prognostic value of vitiligo development on survival.