Research Summary

How Does Melanoma Subtype Influence Cutaneous Immune-Related Adverse Events in Patients Who Use ICI Therapy?

Anthony Calabro, MA

In a recent retrospective multi-institutional cohort study1, researchers found that the presence of cutaneous immune-related adverse events (cirAEs) was associated with better survival among patients receiving immune checkpoint inhibitor (ICI) therapy.

Although previous study results2,3 have confirmed an association between cirAEs and improved survival among those with advanced melanoma treated with ICI therapy, researchers have yet to investigate the role of melanoma subtypes on cirAEs and whether there are any “downstream therapeutic outcomes."

Enter Nguyen and colleagues, whose study objective was to determine the impact of melanoma subtypes on cirAEs and survival among those who received ICI inhibitor therapy.

In their study, Nguyen and colleagues included a total of 747 patients treated with ICI therapy and categorized them into melanoma subsets: acral melanoma, mucosal melanoma, uveal melanoma, nonacral cutaneous melanoma, and melanoma of unknown primary.

Among the 747 patients treated with ICI therapy, 236 patients (31.6%) developed cirAEs, and across all subtypes, cirAEs were associated with decreased mortality (HR = 0.76; p = .042).

Looking into the melanoma subtypes, those with acral melanoma were less likely to develop a cirAE compared with patients with non-acral cutaneous melanoma (p = .016). Patients with acral (HR = 2.04; p = .005), mucosal (HR = 2.30; p < .001), and uveal melanoma (HR = 4.09, p < .001) demonstrated the worst survival among the study participants.

“This is the first study to demonstrate differences in cirAE development among melanoma subtypes,” Nguyen and colleagues concluded. “The presence of cirAEs was associated with better survival. Further, the lower incidence of cirAEs may be a marker of immunotherapy response, which is reflected in the association between acral melanoma and mortality.”


1.     Nguyen N, Wan G, Ugwu-Dike P, et al. Influence of melanoma type on incidence and downstream implications of cutaneous immune-related adverse events in the setting of immune checkpoint inhibitor therapy. J Am Acad Dermatol. Published online February 22, 2023. doi:10.1016/j.jaad.2023.02.014.

2.     Hirotsu KE, Scott MKD, Marquez C, et al. Histologic subtype of cutaneous immune-related adverse events predicts overall survival in patients receiving immune checkpoint inhibitors. J Am Acad Dermatol. 2022;87(3):651-653. doi:10.1016/j.jaad.2021.11.050.

3.     Wu CE, Yang CK, Peng MT, et al. The association between immune-related adverse events and survival outcomes in Asian patients with advanced melanoma receiving anti-PD-1 antibodies. BMC Cancer. 2020;20(1):1018. doi:10.1186/s12885-020-07508-7.