Adjuvant immune checkpoint inhibitor therapy may benefit pediatric patients with stage III melanoma and sentinel lymph node positivity: a case series

Pediatr Hematol Oncol. 2024 Sep;41(6):389-398. doi: 10.1080/08880018.2024.2350455. Epub 2024 May 7.

Abstract

Melanoma is the most common skin cancer in children. While the current literature establishes treatment protocols for adult-type melanoma, very few pediatric-specific studies exist, and children are often excluded from melanoma clinical trials2. We report a case series of 23 pediatric patients aged 2-20 years old diagnosed with melanoma at the University of Rochester Medical Center between 1/1/2011 and 1/1/2022. 9/23 patients were Stage III; all patients underwent wide local excision and 9 received adjuvant therapies. 2/23 (8.7%) patients had recurrence of their malignancy after therapy while 21/23 (91.3%) remained without disease progression; 1 patient died from unknown cause, but the rest are alive and currently without disease. All patients whose initial therapy included nivolumab in addition to wide local excision did not have recurrence or progression of their disease. This case series highlights trends in the presentation, treatment, and outcomes of pediatric melanoma; however, additional multi-center studies are needed to establish the clinical utility of such features in pediatric melanoma.

Keywords: Dermatology; melanoma; neoplasms; nivolumab; pediatrics.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Chemotherapy, Adjuvant
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Immune Checkpoint Inhibitors* / therapeutic use
  • Male
  • Melanoma* / drug therapy
  • Melanoma* / pathology
  • Neoplasm Staging
  • Nivolumab / therapeutic use
  • Sentinel Lymph Node / pathology
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / pathology
  • Young Adult

Substances

  • Immune Checkpoint Inhibitors
  • Nivolumab