What question did this study set out to answer?

Assess the impact of vitiligo-like depigmentation on survival in melanoma patients undergoing immune checkpoint inhibitor treatment.

February 6, 2026Open Access

Vitiligo-Like Depigmentation as a Predictor of Prolonged Response to Immune Checkpoint Inhibitors in Patients With Advanced Melanoma: A Single-Center Experience

Key Points

Assess the impact of vitiligo-like depigmentation on survival in melanoma patients undergoing immune checkpoint inhibitor treatment.
Retrospective analysis of stage III and IV melanoma patients treated with pembrolizumab or nivolumab.
Used Chi-square and Fisher's exact tests for categorical variables.
Estimated progression-free survival and overall survival using the Kaplan-Meier method.
Compared survival rates between patients with and without vitiligo-like depigmentation using log-rank test.
22 out of 109 patients (20.2%) developed vitiligo-like depigmentation.
Median follow-up for VLD patients was 39.4 months, with 59% remaining alive and progression-free after 3 years.
Overall response rate for the VLD group was 72.7%, versus 29.9% for non-VLD patients.
Median progression-free survival was significantly longer in VLD patients (52.862 months vs. 8.148 months).
Median overall survival was also longer for VLD patients, showing a significant association with treatment response.

Abstract

p class=cvGsUA direction-ltr align-justify para-style-body style=text-align: justify;span class=aGcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-noneImmune checkpoint inhibitors (ICIs) immensely improved outcomes in melanoma patients. Vitiligo-like depigmentation (VLD) is a well-documented adverse event of ICIs which is well tolerated and often associated with prolonged response to treatment. The aim of this study was to assess the effect of VLD occurrence on survival in melanoma patients treated with ICIs. /spanspan class=aGcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-noneWe conducted a retrospective analysis among unresectable stage III and stage IV melanoma patients treated with pembrolizumab or nivolumab at the University Clinical Center Niscaron; from May 2017 to February 2024. The Chi-square or Fisherrsquo;s exact test were used to evaluate the categorical variables. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplanndash;Meier method (CI 95%; p lt; 0. 05). Survival between the patients with or without VLD was compared using a log-rank (p lt; 0. 05). /spanspan class=aGcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-noneA total of 109 patients were included, including 22 patients who developed VLD (20. 2%). Median follow-up in the VLD group was 39. 4 months, with 59% still alive and progression-free three years after treatment initiation. The overall response rate (ORR) was 72. 7% vs. 29. 9%, with 31. 8% vs. 13. 8% of complete responses in favor of the VLD subgroup. The occurrence of VLD was associated with significantly longer median PFS (8. 148 vs. 52. 862 months; p = 0. 0001) and median OS (12. 715 vs. NR months; p = 0. 0001). /spanspan class=aGcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-nonePrediction of VLD occurrence is not possible, therefore, it cannot be a predictive parameter per se, however, it can be associated with prolonged response to ICI treatment in patients who develop this adverse event. /span/p

Vitiligo-Like Depigmentation as a Predictor of Prolonged Response to Immune Checkpoint Inhibitors in Patients With Advanced Melanoma: A Single-Center Experience

Key Points

Abstract

Cite This Study