Immunotherapy toxicities in metastatic vulvar and vaginal melanomas: a retrospective cohort study
Bibliographic record
Abstract
This retrospective cohort study examined the factors for patients with metastatic vulvar and vaginal melanomas on immune checkpoint inhibitors. The study included all patients over the age of 18 who received either anti-cytotoxic T-lymphocyte-4 (anti-CTLA-4) therapy or anti-programmed cell death protein-1 (anti-PD-1) therapy at the Sunnybrook Hospital from June 2012 to December 2018. There were 11 patients with vulvar or vaginal melanoma on immune checkpoint inhibitor therapy. The main sites of metastasis included the lungs, lymph nodes, soft tissues, and liver. The majority of patients received prior radiation therapy (7/11) and prior surgical therapy (9/11). There were no differences in overall survival for vulvar or vaginal melanomas on anti-PD-1 vs. anti-CTLA-4 therapy (p > 0.05). There were no significant differences in overall survival for vulvar and vaginal vs. cutaneous melanoma (p > 0.5). There were no significant differences in overall survival in patients with vulvar and vaginal melanoma in the presence vs. absence of immune-related adverse events (p > 0.05), yet there was a significant difference in patients with cutaneous melanoma in the presence vs. absence of immune-related adverse events (p < 0.05). Knowledge of the presentation and outcome of vulvar and vaginal melanomas is important for clinical practice in gynecology.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | high |
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedLabeled directly by 2 models reading the full record.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".