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ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1542293
This article is part of the Research Topic Immunological Aspects and Immunotherapy in Gynecologic Cancers View all 8 articles
Immune checkpoint inhibitor Outcomes and Prognostic Factors in Gynecologic Tract Melanoma: A Single-Center Analysis
Provisionally accepted- 1 West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- 2 Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- 3 Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, China
Introduction: Gynecologic 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. Methods: A 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. Results: Among 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. Conclusion: This 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.
Keywords: Melanoma, Gynecological, Immunotherapy, immune checkpoint inhibitors, prognostic factors
Received: 09 Dec 2024; Accepted: 28 Mar 2025.
Copyright: © 2025 Wang, LI, Li, Zeng and Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jing Zeng, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.