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[翻译文章] 切除的III期和IV期黑色素瘤患者辅助免疫治疗的真实世界证据:CADIM试验最终结果。来自两个三级转诊中心的经验。

[Translated article] Real-World Evidence of Adjuvant Immunotherapy in Resected Stage III and IV Melanoma Patients: CADIM Trial Final Results. Experience From 2 Tertiary Referral Centers.

作者信息

Morellá Fernández M, Balsalobre Yago J, Martínez García J, Peláez Gutiérrez M, López Muñoz A, Silvestre Ballesta A I, Sánchez Lafuente B, Martínez Martín I, Cerezuela Fuentes P

机构信息

Servicio de Oncología Médica, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain.

Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain; Servicio de Oncología Médica, Hospital Universitario Santa Lucía, Cartagena, Spain.

出版信息

Actas Dermosifiliogr. 2025 Mar;116(3):T218-T224. doi: 10.1016/j.ad.2024.12.008. Epub 2024 Dec 24.

Abstract

INTRODUCTION

Clinical trials have validated the use of nivolumab and pembrolizumab as adjuvant therapies regarding relapse-free survival in patients with resected stage III and IV melanoma. Evidence in real-world patients is currently limited.

MATERIAL AND METHOD

The CADIM trial (characterization of adjuvant immunotherapy in melanoma patients) recruited a total of 81 patients with resected stage III and IV melanoma on nivolumab or pembrolizumab as adjuvant therapy from February 2018 to December 2022.

RESULTS

The stage distribution rate was 81.5% (n=71) for stage III, while 15 patients (18.5%) had resected stage IV. Among stage III patients, 38 were stage IIIC (46.9%). With a median follow-up of 22.8 months, the relapse-free survival in the intention-to-treat population was 84% at one year and 81.5% at 2 years. The overall survival rate was 99% at one year and 91.4% at 2 years. Grade 3-4 treatment-related adverse events were reported in 12.3% of the patients.

CONCLUSIONS

This study shows the results of resected stage III and IV melanoma patients on adjuvant therapy with anti-PD-1, and eventually confirmed the safety and efficacy profile described by clinical trials. Comparing clinical trial data with real-world evidence is necessary for a more practical, reliable, and accessible use of these drugs.

摘要

引言

临床试验已证实,纳武利尤单抗和帕博利珠单抗作为辅助疗法可用于已切除的III期和IV期黑色素瘤患者的无复发生存。目前,真实世界患者中的证据有限。

材料与方法

CADIM试验(黑色素瘤患者辅助免疫治疗的特征)从2018年2月至2022年12月共招募了81例接受纳武利尤单抗或帕博利珠单抗辅助治疗的已切除III期和IV期黑色素瘤患者。

结果

III期患者的分期分布率为81.5%(n = 71),而15例(18.5%)患者为已切除的IV期。在III期患者中,38例为IIIC期(46.9%)。中位随访22.8个月时,意向性治疗人群的1年无复发生存率为84%,2年为81.5%。1年总生存率为99%,2年为91.4%。12.3%的患者报告了3 - 4级治疗相关不良事件。

结论

本研究展示了接受抗PD - 1辅助治疗的已切除III期和IV期黑色素瘤患者的结果,并最终证实了临床试验所描述的安全性和疗效。将临床试验数据与真实世界证据进行比较,对于更实际、可靠且可及地使用这些药物而言是必要的。

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