Modern Approach to Melanoma Adjuvant Treatment with Anti-PD1 Immune Check Point Inhibitors or <i>BRAF/MEK</i> Targeted Therapy: Multicenter Real-World Report
Background: The landscape of melanoma management changed as randomized trials have launched adjuvant treatment. Materials and Methods: An analysis of data on 248 consecutive melanoma stage III and IV patients given adjuvant therapy in eight centers (February 2019 to January 2021) was conducted. Resu...
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MDPI AG
2023-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/17/4384 |
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| author | Joanna Placzke Magdalena Rosińska Paweł Sobczuk Marcin Ziętek Natasza Kempa-Kamińska Bożena Cybulska-Stopa Grażyna Kamińska-Winciorek Wiesław Bal Jacek Mackiewicz Łukasz Galus Manuela Las-Jankowska Michał Jankowski Robert Dziura Kamil Drucis Aneta Borkowska Tomasz Świtaj Paweł Rogala Katarzyna Kozak Anna Klimczak Paulina Jagodzińska-Mucha Anna Szumera-Ciećkiewicz Hanna Koseła-Paterczyk Piotr Rutkowski |
| author_facet | Joanna Placzke Magdalena Rosińska Paweł Sobczuk Marcin Ziętek Natasza Kempa-Kamińska Bożena Cybulska-Stopa Grażyna Kamińska-Winciorek Wiesław Bal Jacek Mackiewicz Łukasz Galus Manuela Las-Jankowska Michał Jankowski Robert Dziura Kamil Drucis Aneta Borkowska Tomasz Świtaj Paweł Rogala Katarzyna Kozak Anna Klimczak Paulina Jagodzińska-Mucha Anna Szumera-Ciećkiewicz Hanna Koseła-Paterczyk Piotr Rutkowski |
| author_sort | Joanna Placzke |
| collection | DOAJ |
| description | Background: The landscape of melanoma management changed as randomized trials have launched adjuvant treatment. Materials and Methods: An analysis of data on 248 consecutive melanoma stage III and IV patients given adjuvant therapy in eight centers (February 2019 to January 2021) was conducted. Results: The analyzed cohort comprised 147 melanoma patients given anti-PD1 (33% nivolumab, 26% pembrolizumab), and 101 (41%) were given dabrafenib plus trametinib (DT). The 2-year overall survival (OS), relapse-free survival (RFS), and distant-metastases-free survival (DMFS) rates were 86.7%, 61.4%, and 70.2%, respectively. The disease stage affected only the RFS rate; for stage IV, it was 52.2% (95% CI: 33.4–81.5%) vs. 62.5% (95% CI: 52.3–74.8%) for IIIA-D, <i>p</i> = 0.0033. The type of lymph node surgery before adjuvant therapy did not influence the outcomes. Completion of lymph node dissection cessation after positive SLNB did not affect the results in terms of RFS or OS. Treatment-related adverse events (TRAE) were associated with longer 24-month RFS, with a rate of 68.7% (55.5–84.9%) for TRAE vs. 56.6% (45.8–70%) without TRAE, <i>p</i> = 0.0031. For TRAE of grade ≥ 3, a significant decline in OS to 60.6% (26.9–100%; <i>p</i> = 0.004) was observed. Conclusions: Melanoma adjuvant therapy with anti-PD1 or DT outside clinical trials appears to be effective and comparable with the results of registration studies. Our data support a de-escalating surgery approach in melanoma treatment. |
| first_indexed | 2024-03-10T23:26:37Z |
| format | Article |
| id | doaj.art-484120eb11414e74bddfafad5875e29b |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T23:26:37Z |
| publishDate | 2023-09-01 |
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| record_format | Article |
| series | Cancers |
| spelling | doaj.art-484120eb11414e74bddfafad5875e29b2023-11-19T07:57:00ZengMDPI AGCancers2072-66942023-09-011517438410.3390/cancers15174384Modern Approach to Melanoma Adjuvant Treatment with Anti-PD1 Immune Check Point Inhibitors or <i>BRAF/MEK</i> Targeted Therapy: Multicenter Real-World ReportJoanna Placzke0Magdalena Rosińska1Paweł Sobczuk2Marcin Ziętek3Natasza Kempa-Kamińska4Bożena Cybulska-Stopa5Grażyna Kamińska-Winciorek6Wiesław Bal7Jacek Mackiewicz8Łukasz Galus9Manuela Las-Jankowska10Michał Jankowski11Robert Dziura12Kamil Drucis13Aneta Borkowska14Tomasz Świtaj15Paweł Rogala16Katarzyna Kozak17Anna Klimczak18Paulina Jagodzińska-Mucha19Anna Szumera-Ciećkiewicz20Hanna Koseła-Paterczyk21Piotr Rutkowski22Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Computational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDivision of Surgical Oncology, Department of Oncology, Wroclaw Medical University, 53-413 Wroclaw, PolandDepartment of Clinical Oncology, Wroclaw Comprehensive Cancer Center, 53-413 Wroclaw, PolandDepartment of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 31-115 Kraków, PolandSkin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandSkin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Medical and Experimental Oncology, University of Medical Sciences, 61-701 Poznan, PolandDepartment of Medical and Experimental Oncology, University of Medical Sciences, 61-701 Poznan, PolandDepartment of Clinical Oncology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University and Oncology Centre, 85-094 Bydgoszcz, PolandDepartment of Oncological Surgery, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University and Oncology Centre, 85-094 Bydgoszcz, PolandDepartment of Clinical Oncology, Holy Cross Cancer Center, 25-734 Kielce, PolandDepartment of Surgical Oncology, Medical University of Gdansk, 80-308 Gdańsk, PolandDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandDepartment of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandBackground: The landscape of melanoma management changed as randomized trials have launched adjuvant treatment. Materials and Methods: An analysis of data on 248 consecutive melanoma stage III and IV patients given adjuvant therapy in eight centers (February 2019 to January 2021) was conducted. Results: The analyzed cohort comprised 147 melanoma patients given anti-PD1 (33% nivolumab, 26% pembrolizumab), and 101 (41%) were given dabrafenib plus trametinib (DT). The 2-year overall survival (OS), relapse-free survival (RFS), and distant-metastases-free survival (DMFS) rates were 86.7%, 61.4%, and 70.2%, respectively. The disease stage affected only the RFS rate; for stage IV, it was 52.2% (95% CI: 33.4–81.5%) vs. 62.5% (95% CI: 52.3–74.8%) for IIIA-D, <i>p</i> = 0.0033. The type of lymph node surgery before adjuvant therapy did not influence the outcomes. Completion of lymph node dissection cessation after positive SLNB did not affect the results in terms of RFS or OS. Treatment-related adverse events (TRAE) were associated with longer 24-month RFS, with a rate of 68.7% (55.5–84.9%) for TRAE vs. 56.6% (45.8–70%) without TRAE, <i>p</i> = 0.0031. For TRAE of grade ≥ 3, a significant decline in OS to 60.6% (26.9–100%; <i>p</i> = 0.004) was observed. Conclusions: Melanoma adjuvant therapy with anti-PD1 or DT outside clinical trials appears to be effective and comparable with the results of registration studies. Our data support a de-escalating surgery approach in melanoma treatment.https://www.mdpi.com/2072-6694/15/17/4384melanomaadjuvant treatmenttargeted therapyimmune check point inhibitorsearly-stage melanomasentinel node biopsy |
| spellingShingle | Joanna Placzke Magdalena Rosińska Paweł Sobczuk Marcin Ziętek Natasza Kempa-Kamińska Bożena Cybulska-Stopa Grażyna Kamińska-Winciorek Wiesław Bal Jacek Mackiewicz Łukasz Galus Manuela Las-Jankowska Michał Jankowski Robert Dziura Kamil Drucis Aneta Borkowska Tomasz Świtaj Paweł Rogala Katarzyna Kozak Anna Klimczak Paulina Jagodzińska-Mucha Anna Szumera-Ciećkiewicz Hanna Koseła-Paterczyk Piotr Rutkowski Modern Approach to Melanoma Adjuvant Treatment with Anti-PD1 Immune Check Point Inhibitors or <i>BRAF/MEK</i> Targeted Therapy: Multicenter Real-World Report Cancers melanoma adjuvant treatment targeted therapy immune check point inhibitors early-stage melanoma sentinel node biopsy |
| title | Modern Approach to Melanoma Adjuvant Treatment with Anti-PD1 Immune Check Point Inhibitors or <i>BRAF/MEK</i> Targeted Therapy: Multicenter Real-World Report |
| title_full | Modern Approach to Melanoma Adjuvant Treatment with Anti-PD1 Immune Check Point Inhibitors or <i>BRAF/MEK</i> Targeted Therapy: Multicenter Real-World Report |
| title_fullStr | Modern Approach to Melanoma Adjuvant Treatment with Anti-PD1 Immune Check Point Inhibitors or <i>BRAF/MEK</i> Targeted Therapy: Multicenter Real-World Report |
| title_full_unstemmed | Modern Approach to Melanoma Adjuvant Treatment with Anti-PD1 Immune Check Point Inhibitors or <i>BRAF/MEK</i> Targeted Therapy: Multicenter Real-World Report |
| title_short | Modern Approach to Melanoma Adjuvant Treatment with Anti-PD1 Immune Check Point Inhibitors or <i>BRAF/MEK</i> Targeted Therapy: Multicenter Real-World Report |
| title_sort | modern approach to melanoma adjuvant treatment with anti pd1 immune check point inhibitors or i braf mek i targeted therapy multicenter real world report |
| topic | melanoma adjuvant treatment targeted therapy immune check point inhibitors early-stage melanoma sentinel node biopsy |
| url | https://www.mdpi.com/2072-6694/15/17/4384 |
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