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268 Efficacy and Safety Profiles of Surgical Resection in Patients with Metastatic Gynecologic Melanoma on Immune Checkpoint Inhibitors: A Retrospective Cohort Study


 
 
 Malignant vulvovaginal melanoma is a rare, aggressive malignancy with poor prognosis and no consensus regarding treatment. Few studies to date have comprehensively examined the efficacy and safety of surgical procedures alongside immunotherapy in their treatment.
 
 
 
 We retrospectively analyzed 169 patients with advanced-stage metastatic melanoma who received at least one dose of immunotherapy between June 2012 to December 2018. Descriptive statistics were used, as well as Chi-square statistical analysis to examine associations between immune-related adverse events (irAEs) and treatment response. P-values <0.05 were statistically significant.
 
 
 
 Surgical resection was performed in 63.6% of patients with vulvovaginal melanoma, which was comparable to other melanoma subtypes. From patients with vulvovaginal melanoma who received prior surgery, 80% had progressive disease and 20% response to treatment, compared with 100% progression in patients without prior surgery. Furthermore, patients with vulvovaginal melanoma developed irAEs in 53.8% of the cases. Cutaneous adverse events were overall the most common irAEs and were significantly associated with patient response to ICIs (p = 0.01).
 
 
 
 The majority of patients received surgery prior to immunotherapy. Those who received prior surgery had greater response to immunotherapy compared to those without prior surgery. Surgery and immunotherapy is a unique therapeutic regime to control metastatic vulvovaginal melanoma.
