Tom Baker Cancer Centre, Division of Medical Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Gastrointestinal Cancer and Melanoma Clinical Research Program, Cumming School of Medicine at the University of Calgary and Alberta Health Services, Calgary, AB, Canada.
Oncologist. 2024 Jan 5;29(1):57-66. doi: 10.1093/oncolo/oyad223.
Adjuvant therapies have been approved for resected melanoma based on improved recurrence-free survival. We present early findings from a real-world study on adjuvant treatments for melanoma.
A comprehensive chart review was conducted for patients receiving adjuvant systemic therapy for resected high-risk stages III and IV melanoma. Statistical analysis was performed to assess recurrence-free survival and subgroup differences.
A total of 149 patients (median age = 58.0 years, 61.1% men, 49.7% with BRAF V600E/K genotypes) were included, with 94.6% having resected stage III melanoma. Anti-PD-1 immunotherapy was received by 86.5% of patients, while 13.4% received BRAF-targeted therapy. At a median follow-up of 22.4 months, the recurrence rate was 31.5%, with 1-year and 2-year recurrence-free survival rates of 79% and 62%, respectively. Similar recurrence rates were observed between anti-PD-1 immunotherapy and BRAF-targeted therapy. Long-term toxicity affected 27.4% of patients, with endocrinopathies and late-emergent immune-related adverse events being common.
Real-world adjuvant systemic therapy aligns with clinical trial practice. Recurrence rates remain high despite treatment, and long-term toxicities, including endocrinopathies and chronic inflammatory conditions, are not uncommon.
辅助疗法已基于改善无复发生存率而被批准用于切除的黑色素瘤。我们呈现了一项关于黑色素瘤辅助治疗的真实世界研究的早期发现。
对接受辅助全身治疗的切除高风险 III 期和 IV 期黑色素瘤患者进行了全面的病历回顾。进行了统计分析以评估无复发生存率和亚组差异。
共纳入 149 例患者(中位年龄为 58.0 岁,61.1%为男性,49.7%为 BRAF V600E/K 基因型),94.6%的患者为 III 期黑色素瘤切除。86.5%的患者接受了抗 PD-1 免疫治疗,而 13.4%的患者接受了 BRAF 靶向治疗。在中位随访 22.4 个月时,复发率为 31.5%,1 年和 2 年无复发生存率分别为 79%和 62%。抗 PD-1 免疫治疗和 BRAF 靶向治疗之间观察到相似的复发率。长期毒性影响了 27.4%的患者,内分泌疾病和晚期出现的免疫相关不良事件很常见。
真实世界的辅助全身治疗与临床试验实践一致。尽管进行了治疗,但复发率仍然很高,长期毒性,包括内分泌疾病和慢性炎症性疾病,并不少见。