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Characteristics and quality of life of nine-year survivors with metastatic melanoma treated with pembrolizumab beyond second-line therapy

Background - Immune checkpoint blockers have improved survival in metastatic melanoma. Long-term quality of life (QoL) and sequelae from immune-related adverse events (irAE) are therefore of increasing importance. This study reports long-term outcomes from a real-world cohort of patients with stage...

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Main Authors: Dugas-Breit, Susanne (Author) , Forschner, A. (Author) , Erdmann, M. (Author) , Gutzmer, R. (Author) , Kähler, K. C. (Author) , Holst, I. (Author) , Brekner, A. (Author) , Franklin, C. (Author) , Sindrilaru, A. (Author) , Zimmer, L. (Author) , Heinzerling, L. (Author) , Utikal, Jochen (Author) , Meier, F. (Author) , Bender, A. (Author) , Berking, C. (Author) , Garbe, C. (Author) , Weichenthal, Michael (Author) , Schadendorf, D. (Author) , Hauschild, A. (Author) , Gschnell, M. (Author) , Mohr, P. (Author) , Hassel, Jessica C. (Author)
Format: Article (Journal)
Language:English
Published: 17 January 2026
In: European journal of cancer
Year: 2026, Volume: 233, Pages: 1-12
ISSN:1879-0852
DOI:10.1016/j.ejca.2025.116149
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ejca.2025.116149
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0959804925010354
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Author Notes:S. Dugas-Breit, A. Forschner, M. Erdmann, R. Gutzmer, K.C. Kähler, I. Holst, A. Brekner, C. Franklin, A. Sindrilaru, L. Zimmer, L. Heinzerling, J. Utikal, F. Meier, A. Bender, C. Berking, C. Garbe, M. Weichenthal, D. Schadendorf, A. Hauschild, M. Gschnell, P. Mohr, J.C. Hassel
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Summary:Background - Immune checkpoint blockers have improved survival in metastatic melanoma. Long-term quality of life (QoL) and sequelae from immune-related adverse events (irAE) are therefore of increasing importance. This study reports long-term outcomes from a real-world cohort of patients with stage IV melanoma treated with pembrolizumab after progression on ipilimumab and, if indicated, BRAF/MEK inhibition. - Methods - Survival of patients who started treatment with pembrolizumab within the German Expanded Access Program (EAP) were evaluated in Cancer centers that included ≥10 patients. For survivors, baseline characteristics, best response and irAEs were assessed retrospectively. In addition, in a cross-sectional approach patients were interviewed for persisting symptoms and QoL (WHO-5, EORTC QLQ-C30). - Results - Of 325 treated patients, 55 (17%) survived after a median follow-up of 9.1 years. At treatment start, survivors had a median age of 60 years; 60% were male; 40% BRAF-mutated; 66% stage M1c/d. Overall response rate was 89%, including 69% complete responses. Progression occurred in 22 (40%). As of May 2024, 46 (84%) were disease-free, 7 (13%) had controlled disease, and 2 (4%) progressed. IrAEs occurred in 39 (71%), with 15 (27%) grade 3/4. Persisting symptoms were reported by 19 (35%), mainly endocrine insufficiencies, vitiligo, and fatigue. Median WHO-5 score was 76%, and mean QLQ-C30 global health 70.1. Survivors with prior irAEs had significantly lower QoL (WHO-5, p=0.026) and social functioning (QLQ-C30, p=0.046). Of 21 survivors <65 years (38%), 11 (20%) were employed at follow-up. - Conclusion - Pembrolizumab induced long-term survival in a real-world pretreated melanoma cohort. Despite persisting symptoms in one third, QoL, when measured by standard instruments, was good for most survivors nearly a decade after treatment.
Item Description:Online verfügbar: 29. November 2025, Artikelversion: 11. Dezember 2025
Gesehen am 16.02.2026
Physical Description:Online Resource
ISSN:1879-0852
DOI:10.1016/j.ejca.2025.116149

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