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