Investigating Chronic Toxicity, Diet, Patient-Reported Outcomes and the Microbiome in Immunotherapy-Treated Metastatic Melanoma Survivors: A New Frontier.

Sixty percent of long-term ICB-treated metastatic melanoma survivors were experiencing chronic toxicity persisting more than 6 months after completion of therapy.

• Cohort included 48 patients with a history of metastatic melanoma who initiated ICB treatment at least 3 years earlier and were not currently on treatment.
• Patients were prospectively enrolled from a melanoma survivorship clinic.
• Chronic toxicity was defined as persisting >6 months after completion of therapy.
• Clinicopathological characteristics and experience of irAEs and CT were extracted retrospectively from the medical record.

Clinically relevant levels of depression and anxiety symptoms were reported by 16% and 20% of survivors, respectively.

• Participants completed screening questionnaires for depression and anxiety.
• 16% of the overall cohort reported clinically relevant levels of depression symptoms.
• 20% of the overall cohort reported clinically relevant levels of anxiety symptoms.
• These mental health assessments were conducted in a cohort of 48 long-term ICB-treated melanoma survivors.

Significant differences in overall gut microbiome composition were observed between survivors with and without chronic toxicity.

• The gut microbiome was characterized via metagenomic sequencing in a subsample of n = 39 participants.
• The difference in gut microbiome composition between survivors with and without CT was statistically significant (p = 0.02).
• This finding suggests a potential link between chronic post-treatment toxicity and distinct microbial features.

Consumption of fruit and vegetables was inversely associated with anxiety symptoms in ICB-treated melanoma survivors.

• The inverse association between fruit and vegetable consumption and anxiety was statistically significant (ρ = 0.3, p = 0.038).
• Diet was assessed via questionnaire as part of participant screening.
• This association was observed in the overall cohort of 48 survivors.

Added sugar consumption was correlated with the severity of experienced symptoms, including pain, fatigue, and shortness of breath.

• Added sugar consumption was correlated with symptom severity with ρ = 0.4 and p = 0.003.
• Pronounced associations were observed across the spectrum of symptoms, including pain, fatigue, and shortness of breath (p < 0.05 for each).
• Diet was assessed via participant-completed screening questionnaires.
• These associations were observed in the overall cohort of 48 long-term survivors.

The study enrolled long-term metastatic melanoma survivors who had initiated immune checkpoint blockade treatment at least 3 years prior and were no longer on treatment.

• 48 patients were prospectively enrolled from a melanoma survivorship clinic.
• Eligibility required initiation of ICB treatment at least 3 years earlier.
• Participants were not currently on treatment at the time of enrollment.
• Participants completed screening questionnaires for depression, anxiety, diet, and physical activity.