Immune checkpoint inhibitor outcomes and prognostic factors in gynecologic tract melanoma: a single-center analysis

IntroductionGynecologic tract melanoma (GTM) is a rare and aggressive malignancy with limited treatment options and poor prognosis. This study aims to evaluate the outcomes of immune checkpoint inhibitors (ICIs) in patients with GTM and identify prognostic factors influencing survival.MethodsA retro...

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Main Authors: Jianzhang Wang, Kemin Li, Rui Li, Jing Zeng, Rutie Yin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1542293/full
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author Jianzhang Wang
Kemin Li
Kemin Li
Rui Li
Rui Li
Jing Zeng
Jing Zeng
Rutie Yin
Rutie Yin
author_facet Jianzhang Wang
Kemin Li
Kemin Li
Rui Li
Rui Li
Jing Zeng
Jing Zeng
Rutie Yin
Rutie Yin
author_sort Jianzhang Wang
collection DOAJ
description IntroductionGynecologic tract melanoma (GTM) is a rare and aggressive malignancy with limited treatment options and poor prognosis. This study aims to evaluate the outcomes of immune checkpoint inhibitors (ICIs) in patients with GTM and identify prognostic factors influencing survival.MethodsA retrospective analysis was conducted on 45 patients diagnosed with GTM at West China Second University Hospital from January 2019 to September 2024. Data on demographics, clinical characteristics, treatments, and outcomes were collected. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier curves and Cox proportional-hazards models.ResultsAmong 45 patients, 24 had vaginal melanoma, 18 had vulvar melanoma, and 3 had cervical melanoma. ICIs were administered to 21 patients, but no significant survival benefit was observed. The 1-, 3-, and 5-year survival rates were 87%, 63%, and 31%, respectively. Univariate analysis revealed that patients with a family history of cancer (FHC) and those with lactate dehydrogenase (LDH) levels ≤230 had better PFS. Additionally, FHC, American Joint Committee on Cancer (AJCC) stage I-II, absence of pelvic lymph node metastasis, and LDH levels ≤230 were associated with improved OS. However, in multivariate analysis, only LDH was significantly associated with OS.ConclusionThis single-center study suggests that ICIs have limited efficacy in treating GTM, emphasizing the need for further investigation through larger, multicenter clinical trials. Prognostic factors such as FHC, AJCC stage, lymph node involvement, and LDH levels may aid in risk stratification and personalized treatment planning. However, due to the nature of this study, external cohorts are still needed for validation.
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spelling doaj-art-04c796f003fb40ed83b06f790df261a52025-08-20T03:08:29ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-04-011610.3389/fimmu.2025.15422931542293Immune checkpoint inhibitor outcomes and prognostic factors in gynecologic tract melanoma: a single-center analysisJianzhang Wang0Kemin Li1Kemin Li2Rui Li3Rui Li4Jing Zeng5Jing Zeng6Rutie Yin7Rutie Yin8West China School of Medicine, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaIntroductionGynecologic tract melanoma (GTM) is a rare and aggressive malignancy with limited treatment options and poor prognosis. This study aims to evaluate the outcomes of immune checkpoint inhibitors (ICIs) in patients with GTM and identify prognostic factors influencing survival.MethodsA retrospective analysis was conducted on 45 patients diagnosed with GTM at West China Second University Hospital from January 2019 to September 2024. Data on demographics, clinical characteristics, treatments, and outcomes were collected. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier curves and Cox proportional-hazards models.ResultsAmong 45 patients, 24 had vaginal melanoma, 18 had vulvar melanoma, and 3 had cervical melanoma. ICIs were administered to 21 patients, but no significant survival benefit was observed. The 1-, 3-, and 5-year survival rates were 87%, 63%, and 31%, respectively. Univariate analysis revealed that patients with a family history of cancer (FHC) and those with lactate dehydrogenase (LDH) levels ≤230 had better PFS. Additionally, FHC, American Joint Committee on Cancer (AJCC) stage I-II, absence of pelvic lymph node metastasis, and LDH levels ≤230 were associated with improved OS. However, in multivariate analysis, only LDH was significantly associated with OS.ConclusionThis single-center study suggests that ICIs have limited efficacy in treating GTM, emphasizing the need for further investigation through larger, multicenter clinical trials. Prognostic factors such as FHC, AJCC stage, lymph node involvement, and LDH levels may aid in risk stratification and personalized treatment planning. However, due to the nature of this study, external cohorts are still needed for validation.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1542293/fullmelanomagynecologicalimmunotherapyimmune checkpoint inhibitorsprognostic factors
spellingShingle Jianzhang Wang
Kemin Li
Kemin Li
Rui Li
Rui Li
Jing Zeng
Jing Zeng
Rutie Yin
Rutie Yin
Immune checkpoint inhibitor outcomes and prognostic factors in gynecologic tract melanoma: a single-center analysis
Frontiers in Immunology
melanoma
gynecological
immunotherapy
immune checkpoint inhibitors
prognostic factors
title Immune checkpoint inhibitor outcomes and prognostic factors in gynecologic tract melanoma: a single-center analysis
title_full Immune checkpoint inhibitor outcomes and prognostic factors in gynecologic tract melanoma: a single-center analysis
title_fullStr Immune checkpoint inhibitor outcomes and prognostic factors in gynecologic tract melanoma: a single-center analysis
title_full_unstemmed Immune checkpoint inhibitor outcomes and prognostic factors in gynecologic tract melanoma: a single-center analysis
title_short Immune checkpoint inhibitor outcomes and prognostic factors in gynecologic tract melanoma: a single-center analysis
title_sort immune checkpoint inhibitor outcomes and prognostic factors in gynecologic tract melanoma a single center analysis
topic melanoma
gynecological
immunotherapy
immune checkpoint inhibitors
prognostic factors
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1542293/full
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