Adjuvant Immunotherapy After Resected Melanoma: Survival Outcomes, Prognostic Factors and Patterns of Relapse
Por:
Martinez-Recio, S, Molina-Pérez, MA, Muñoz-Couselo, E, Sevillano-Tripero, AR, Aya, F, Arance, A, Orrillo, M, Martin-Liberal, J, Fernandez-Morales, L, Lesta, R, Quindós-Varela, M, Nieva, M, Vidal, J, Martinez-Perez, D, Barba, A, Majem, M
Publicada:
1 ene 2025
Resumen:
Background: Anti-PD-1-based immunotherapy has improved outcomes in stage IIB to IV resected melanoma patients in clinical trials. However, little is known about real-world outcomes, prognostic factors and patterns of relapse. Methods: This is a retrospective multicenter observational study including patients with resected melanoma treated with subsequent anti-PD-1-based adjuvant immunotherapy. Data on clinical and demographic characteristics, delivered treatment, prognostic factors, time and pattern of relapse were collected. Results: We included 245 patients from eight centers; 4% of patients were at stage IIB-C, 80% at stage IIIA-D and 16% at stage IV. Recurrence-free survival (RFS) rates at 18 and 36 months were 60% and 48%, respectively, with a median RFS of 33.7 months. Prognostic factors associated with recurrence were melanoma primary site (HR 2.64, 95% CI 1.15-6.01) and starting adjuvant therapy more than 12 weeks after the last resection (HR 1.68, 95% CI 1.13-2.5); presence of serious immune-related adverse events was associated with better RFS (HR 0.4, 95% CI 0.19-0.87). Early relapses accounted for 63% of the total recurrences, with a higher number of metastatic sites (18%); in contrast, late relapses presented more frequently with brain metastases (20%). Conclusions: In our patients with resected melanoma who underwent anti-PD-1-based adjuvant immunotherapy, survival outcomes were worse than those reported in clinical trials. Primary melanoma site and time interval between the last resection and the start of adjuvant therapy were associated with survival.
Filiaciones:
Martinez-Recio, S:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona 08025, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona 08193, Spain
Molina-Pérez, MA:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona 08025, Spain
Muñoz-Couselo, E:
Hosp Univ Vall Hebron, Dept Med Oncol, Vall Hebron Instute Oncol VHIO, Barcelona 08035, Spain
Sevillano-Tripero, AR:
Hosp Univ Getafe, Dept Med Oncol, Madrid 28905, Spain
Aya, F:
Hosp Clin & Univ, Dept Med Oncol, Barcelona 08036, Spain
Arance, A:
Hosp Clin & Univ, Dept Med Oncol, Barcelona 08036, Spain
Orrillo, M:
Inst Catala Oncol ICO, Dept Med Oncol, Barcelona 08908, Spain
Martin-Liberal, J:
Inst Catala Oncol ICO, Dept Med Oncol, Barcelona 08908, Spain
Fernandez-Morales, L:
Hosp Univ Parc Tauli, Dept Med Oncol, Sabadell 08208, Spain
Lesta, R:
Hosp Univ A Coruna CHUAC, Dept Med Oncol, Coruna 15006, Spain
Quindós-Varela, M:
Hosp Univ A Coruna CHUAC, Dept Med Oncol, Coruna 15006, Spain
Nieva, M:
Hosp Mar, Dept Med Oncol, Parc Salut Mar, Barcelona 08003, Spain
Vidal, J:
Hosp Mar, Dept Med Oncol, Parc Salut Mar, Barcelona 08003, Spain
Martinez-Perez, D:
Hosp Cent Asturias HUCA, Dept Med Oncol, Oviedo 33011, Spain
Barba, A:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona 08025, Spain
Majem, M:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona 08025, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona 08193, Spain
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