{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:10:55Z","timestamp":1790111455109,"version":"4.0.1"},"reference-count":29,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T00:00:00Z","timestamp":1603324800000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2020,9,27]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Skin cancers are known for their strong immunogenicity, which may contribute to a high treatment efficacy of immune checkpoint inhibition (ICI). However, a considerable proportion of patients with skin cancer is immuno-compromised by concomitant diseases. Due to their previous exclusion from clinical trials, the ICI treatment efficacy is poorly investigated in these patients. The present study analyzed the ICI treatment outcome in advanced patients with skin cancer with a concomitant hematological malignancy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective multicenter study included patients who were treated with ICI for locally advanced or metastatic melanoma (MM), cutaneous squamous cell carcinoma (cSCC), or Merkel cell carcinoma (MCC), and had a previous diagnosis of a hematological malignancy irrespective of disease activity or need of therapy at ICI treatment start. Comparator patient cohorts without concomitant hematological malignancy were extracted from the prospective multicenter skin cancer registry ADOREG. Treatment outcome was measured as best overall response, progression-free (PFS), and overall survival (OS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>84 patients (MM, n=52; cSCC, n=15; MCC, n=17) with concomitant hematological malignancy were identified at 20 skin cancer centers. The most frequent concomitant hematological malignancies were non-Hodgkin\u2019s lymphoma (n=70), with chronic lymphocytic leukemia (n=32) being the largest entity. While 9 patients received ICI in an adjuvant setting, 75 patients were treated for advanced non-resectable disease (55 anti-PD-1; 8 anti-PD-L1; 5 anti-CTLA-4; 7 combinations). In the latter 75 patients, best objective response (complete response+partial response) was 28.0%, disease stabilization was 25.3%, and 38.6% showed progressive disease (PD). Subdivided by skin cancer entity, best objective response was 31.1% (MM), 26.7% (cSCC), and 18.8% (MCC). Median PFS was 8.4 months (MM), 4.0 months (cSCC), and 5.7 months (MCC). 1-year OS rates were 78.4% (MM), 65.8% (cSCC), and 47.4% (MCC). Comparison with respective ADOREG patient cohorts without hematological malignancy (n=392) revealed no relevant differences in ICI therapy outcome for MM and MCC, but a significantly reduced PFS for cSCC (p=0.002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>ICI therapy showed efficacy in advanced patients with skin cancer with a concomitant hematological malignancy. Compared with patients without hematological malignancy, the observed ICI therapy outcome was impaired in cSCC, but not in MM or MCC patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jitc-2020-000897","type":"journal-article","created":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T17:23:00Z","timestamp":1603387380000},"page":"e000897","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":56,"title":["Immune checkpoint inhibition therapy for advanced skin cancer in patients with concomitant hematological malignancy: a retrospective multicenter DeCOG study of 84 patients"],"prefix":"10.1136","volume":"8","author":[{"given":"Ulrike","family":"Leiter","sequence":"first","affiliation":[{"name":"Department of Dermatology, University Hospital T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Loquai","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Johannes Gutenberg University Hospital Mainz, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Reinhardt","sequence":"additional","affiliation":[{"name":"Skin Cancer Center at the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7850-3199","authenticated-orcid":false,"given":"David","family":"Rafei-Shamsabadi","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, University Medical Center Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Gutzmer","sequence":"additional","affiliation":[{"name":"Skin Cancer Center, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Kaehler","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Schleswig-Holstein - Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Heinzerling","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica C","family":"Hassel","sequence":"additional","affiliation":[{"name":"Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Glutsch","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Sirokay","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Schlecht","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital Dortmund, Dortmund, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"R\u00fcbben","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Aachen, Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7862-3695","authenticated-orcid":false,"given":"Thilo","family":"Gambichler","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Ruhr University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Schatton","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Heinrich Heine University Medical Faculty, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pfoehler","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Saarland University Medical Center, Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Franklin","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Terheyden","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Universit\u00e4tsklinikum Schleswig-Holstein - Campus L\u00fcbeck, L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Haferkamp","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Mohr","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Bischof","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Livingstone","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, 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