PURPOSE The immune checkpoint inhibitors (ICIs) have resulted in subgroups of patients with metastatic melanoma achieving high-quality durable responses. Metastatic melanoma survivors are a new population in the era of cancer survivorship. The aim of this study was to evaluate metastatic melanoma survivors in terms of health-related quality of life (HRQoL), immune-related adverse events (irAEs) and exposure to immunosuppressive agents in a large single centre in the UK. METHODS We defined the survivor population as patients with a diagnosis of metastatic melanoma who achieved a durable response to an ICI and had been followed-up for a minimum of 12 months from initiation of ICI without disease progression. HRQoL was assessed using SF-36. Electronic health records were accessed to collect data on demographics, treatments, irAEs and survival. HRQoL data was compared with two norm-based datasets. RESULTS Eighty-four metastatic melanoma survivors were eligible and 87% (N = 73) completed the SF-36. ICI-related toxicity of any grade occurred in 92% of patients and 43% had experienced a grade 3 or 4 toxicity. Almost half (49%) of the patients required steroids for the treatment of ICI-related toxicity, whilst 14% required treatment with an immunosuppressive agent beyond steroids. Melanoma survivors had statistically significant lower HRQoL scores with regard to physical, social and physical role functioning and general health compared with the normative population. There was a trend towards inferior scores in patients with previous exposure to ipilimumab compared with those never exposed to ipilimumab. CONCLUSIONS Our results show that metastatic melanoma survivors have potentially experienced significant ICI-related toxicity and experience significant impairments in specific HRQoL domains. Future service planning is required to meet this population's unique survivorship needs.

中文翻译：

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免疫治疗幸存者群体：接受免疫检查点抑制剂治疗的转移性黑色素瘤患者的健康相关生活质量和毒性。

目的免疫检查点抑制剂（ICIs）已导致转移性黑色素瘤患者亚组获得高质量的持久应答。转移性黑色素瘤幸存者是癌症幸存者时代的新人群。这项研究的目的是从健康相关的生活质量（HRQoL），免疫相关的不良事件（irAEs）以及在英国一个大型单一中心中接触免疫抑制剂的角度评估转移性黑色素瘤幸存者。方法我们将幸存者人群定义为诊断为转移性黑色素瘤的患者，这些患者对ICI产生了持久的反应，并且从开始ICI开始随访了至少12个月而没有疾病进展。使用SF-36评估HRQoL。访问电子健康记录以收集有关人口统计学，治疗，irAE和生存的数据。将HRQoL数据与两个基于规范的数据集进行了比较。结果八十四名转移性黑色素瘤幸存者符合条件，其中87％（N = 73）完成了SF-36。92％的患者发生了任何等级的ICI相关毒性，其中43％经历了3或4级毒性。几乎一半（49％）的患者需要类固醇激素治疗ICI相关毒性，而14％的患者需要使用类固醇激素以外的免疫抑制剂治疗。与正常人群相比，黑色素瘤幸存者在身体，社会和身体角色功能以及总体健康方面的HRQoL得分在统计学上显着降低。与以前从未接触过ipilimumab的患者相比，以前接触ipilimumab的患者存在得分较低的趋势。结论我们的结果表明，转移性黑色素瘤幸存者可能经历了明显的ICI相关毒性，并且在特定的HRQoL域中经历了明显的损伤。需要未来的服务计划来满足该人群独特的生存需求。