Long-term follow-up of real-world adjuvant anti-PD-1 checkpoint inhibition and targeted therapy in patients with stage III melanoma
Purpose: Adjuvant treatment with immune checkpoint inhibition (PD-1) and targeted therapy (TT) with BRAF + MEK inhibitors significantly improved recurrence-free survival (RFS) of patients with stage III melanoma. We investigated efficacy of adjuvant therapy with PD-1 or TT under real-world condition...
Salvato in:
| Autori principali: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Natura: | Article (Journal) |
| Lingua: | inglese |
| Pubblicazione: |
September 2025
|
| In: |
Journal of clinical oncology
Year: 2025, Volume: 43, Fascicolo: 25, Pages: 2793-2805 |
| ISSN: | 1527-7755 |
| DOI: | 10.1200/JCO-24-02776 |
| Accesso online: | Resolving-System, lizenzpflichtig, Volltext: https://doi.org/10.1200/JCO-24-02776 Verlag, lizenzpflichtig, Volltext: https://ascopubs.org/doi/10.1200/JCO-24-02776 
|
| Note sull'autore: | Georg C. Lodde, Jessica C. Hassel, Imke Von Wasielewski, Friedegund Meier, Peter Mohr, Katharina Kähler, Axel Hauschild, Valerie Glutsch, Henner Stege, Carola Berking, Svea Hüning, Julia Huynh, Ralf Gutzmer, Lydia Reinhardt, Bastian Schilling, Carmen Loquai, Michael Erdmann, Andreas Stang, Bernd Kowall, Wolfgang Galetzka, Alexander Roesch, Daniel Tilkorn, Selma Ugurel, Lisa Zimmer, Dirk Schadendorf, Andrea Forschner, and Elisabeth Livingstone |
| Riassunto: | Purpose: Adjuvant treatment with immune checkpoint inhibition (PD-1) and targeted therapy (TT) with BRAF + MEK inhibitors significantly improved recurrence-free survival (RFS) of patients with stage III melanoma. We investigated efficacy of adjuvant therapy with PD-1 or TT under real-world conditions. Materials and methods: A total of 589 patients with stage III melanoma who started adjuvant PD-1 or TT between June 2018 and September 2019 from 11 major German Dermatologic Cooperative Oncology Group skin cancer centers were followed for 4 years. End points were RFS, overall survival (OS), and melanoma-specific survival. Survival analyses and adjusted hazard ratios (HRs) were estimated with Kaplan-Meier and Cox proportional hazards model, inverse probability treatment weighting, and propensity score matching. Results: RFS at 48 months was 42.9% (95% CI, 38.5 to 47.8) for all PD-1 patients and 52.6% (95% CI, 43.6 to 63.3) for TT patients. Among patients with BRAF mutation, rate of recurrence was higher for PD-1 compared with TT (HR, 1.57 [95% CI, 1.09 to 2.26]). OS at 4 years was 80.8% (95% CI, 73.6 to 88.7) for PD-1-treated patients with BRAF mutation and 87.3% (95% CI, 81.0 to 94.0) for TT patients. Patients starting adjuvant PD-1 after resection of macroscopic lymph node metastases had a higher risk of rapid recurrence (1-year RFS all PD-1 58%) compared with 87% in TT patients. Rate of recurrence after premature discontinuation (≤6 v >6 months treatment) was higher in TT patients (HR, 1.47 [95% CI, 0.67 to 3.23]), but not in PD-1 patients (HR, 1.07 [95% CI, 0.73 to 1.55]). Conclusion: PD-1-treated patients with BRAF mutation had a markedly higher rate of relapse compared with TT patients. Rapid recurrences occurred particularly in PD-1-treated patients with previous macroscopic lymph node metastasis. Treatment duration shorter than 6 months did not negatively affect RFS in PD-1, but in TT patients. This real-world study shows a benefit of adjuvant TT over adjuvant PD-1 in patients with BRAF-mutated stage III melanoma. |
|---|---|
| Descrizione del documento: | Online veröffentlicht am: 3. Juni 2025 Gesehen am 28.05.2026 |
| Descrizione fisica: | Online Resource |
| ISSN: | 1527-7755 |
| DOI: | 10.1200/JCO-24-02776 |