Enhanced overall and progression-free survival in advanced melanoma patients undergoing targeted therapy alongside antithrombotic treatment: insights from a multicenter study involving 1296 patients from the prospective skin cancer registry ADOReg
Background - Targeted therapies (TT) improve outcomes in BRAF-mutant melanoma. Pre-clinical data suggest that anticoagulation (AC) and platelet aggregation inhibition (PAI) may have antitumoral effects. We evaluated the impact of concomitant AC or PAI on outcomes in patients receiving TT. - Methods...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
5 February 2026
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| In: |
European journal of cancer
Year: 2026, Volume: 234, Pages: 1-10 |
| ISSN: | 1879-0852 |
| DOI: | 10.1016/j.ejca.2025.116195 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ejca.2025.116195 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0959804925010810 
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| Author Notes: | Noah Zimmermann, Julian Kött, Tim Zell, Ali Zeinal Abedini, Chiara L. Blomen, Stella Belz, Benjamin Deitert, Isabel Heidrich, Glenn Geidel, Alessandra Rünger, Daniel J. Smit, Michael Weichenthal, Selma Ugurel, Ulrike Leiter, Carola Berking, Ralf Gutzmer, Dirk Schadendorf, Imke von Wasielewski, Peter Mohr, Friedegund Meier, Rudolf Herbst, Jochen Utikal, Patrick Terheyden, Sebastian Haferkamp, Claudia Pföhler, Martin Kaatz, Fabian Ziller, Jens Ulrich, Frank Meiss, Alexander T. Bauer, Stefan W. Schneider, Christoffer Gebhardt |
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| 245 | 1 | 0 | |a Enhanced overall and progression-free survival in advanced melanoma patients undergoing targeted therapy alongside antithrombotic treatment |b insights from a multicenter study involving 1296 patients from the prospective skin cancer registry ADOReg |c Noah Zimmermann, Julian Kött, Tim Zell, Ali Zeinal Abedini, Chiara L. Blomen, Stella Belz, Benjamin Deitert, Isabel Heidrich, Glenn Geidel, Alessandra Rünger, Daniel J. Smit, Michael Weichenthal, Selma Ugurel, Ulrike Leiter, Carola Berking, Ralf Gutzmer, Dirk Schadendorf, Imke von Wasielewski, Peter Mohr, Friedegund Meier, Rudolf Herbst, Jochen Utikal, Patrick Terheyden, Sebastian Haferkamp, Claudia Pföhler, Martin Kaatz, Fabian Ziller, Jens Ulrich, Frank Meiss, Alexander T. Bauer, Stefan W. Schneider, Christoffer Gebhardt |
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| 520 | |a Background - Targeted therapies (TT) improve outcomes in BRAF-mutant melanoma. Pre-clinical data suggest that anticoagulation (AC) and platelet aggregation inhibition (PAI) may have antitumoral effects. We evaluated the impact of concomitant AC or PAI on outcomes in patients receiving TT. - Methods - We analyzed 1296 patients with unresectable stage III-IV BRAF-mutant melanoma treated with BRAF plus MEK inhibitors (2016-2024) in the prospective multicenter ADOReg registry. Patients were categorized as receiving no antithrombotic therapy (ATT; n=1125), PAI (n=73; acetylsalicylic acid or clopidogrel), or AC (n=98; direct oral anticoagulants, low-molecular-weight heparin, or vitamin K antagonists). - Results - Median follow-up was 1.3 years. Compared with patients without ATT, those receiving AC had significantly improved 12-month progression-free survival (PFS; HR 0.55, 95 % CI 0.39-0.78, p=0.001) and overall survival (OS; HR 0.35, 95 % CI 0.19-0.64, p=0.001). Direct oral anticoagulants showed the most pronounced PFS benefit (HR 0.40, 95 % CI 0.25-0.64, p<0.001). PAI was not associated with a significant difference in PFS, but multivariable Cox regression indicated a reduced hazard of death (HR 0.48, 95 % CI 0.27-0.87, p=0.015). - Conclusion - Concomitant AC, particularly factor Xa-inhibiting direct oral anticoagulants, was associated with improved survival in melanoma patients undergoing TT. These findings support prospective trials evaluating AC as concomitant therapy in advanced melanoma. | ||
| 650 | 4 | |a Anticoagulation | |
| 650 | 4 | |a Melanoma | |
| 650 | 4 | |a Targeted therapy | |
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| 700 | 1 | |a Terheyden, Patrick |e VerfasserIn |4 aut | |
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