Influence of adjuvant therapies on organ-specific recurrence of cutaneous melanoma: A multicenter study on 1383 patients of the prospective DeCOG registry ADOReg

Wohlfeil SA, Kranzmann L, Weiß C, von Wasielewski I, Klespe KC, Kähler KC, Weichenthal M, Schadendorf D, Zimmer L, Mohr P, Meier F, Pfoehler C, Berking C, Heppt M, Herbst R, Kreuter A, Gutzmer R, Ulrich J, Meiss F, Gebhardt C, Dippel E, Leiter U, Schilling B, Ugurel S, Utikal J (2024)

Publication Type: Journal article

Publication year: 2024

Journal

DOI: 10.1002/ijc.35078

Abstract

This study investigated whether adjuvant treatments in stage III cutaneous melanoma (CM) influenced patterns of recurrence. Patients with primary (n = 1033) or relapsed CM (n = 350) who received adjuvant therapies with Nivolumab (N), Pembrolizumab (P), or Dabrafenib and Trametinib (D + T) were extracted from the prospective multicenter real-world skin cancer registry ADOReg. Endpoints were progression-free survival (PFS), distant metastasis-free survival (DMFS), organ-specific DMFS, and overall survival (OS). For primary cases, D + T indicated an improved PFS (1- and 2-year PFS: 90.9%; 82.7%) as compared to P (81.0%, 73.9%; p =.0208), or N (83.8%, 75.2%; p =.0539). BRAF-mutated(mut) CM demonstrated significantly lower PFS (p =.0022) and decreased DMFS (p =.0580) when treated with immune checkpoint inhibitor (ICI) instead of D + T. Besides, NRAS-mut CM tended to perform worse than wt CM upon ICI (PFS: p =.1349; DMFS: p =.0540). OS was similar between the groups. Relapsed cases showed decreased PFS, DMFS, and OS in comparison to primary (all: p <.001), without significant differences between the subgroups. Organ-specific DMFS was significantly altered for primary cases with bone (p =.0367) or brain metastases (p =.0202). In relapsed CM, the frequency of liver (D + T: 1.5%; P: 12%; N: 9%) and LN metastases (D + T: 1.5%; P: 12%; N: 10.2%) was significantly lower with adjuvant D + T than ICI. NRAS-mut CM showed increased recurrence in primary and relapsed cases. These data show that adjuvant D + T is superior to ICI in primary BRAF-mut CM.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Mannheim Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Deutsches Krebsforschungszentrum (DKFZ) Germany (DE) Elbe Kliniken Stade-Buxtehude Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Universitätsklinikum des Saarlandes (UKS) Germany (DE) HELIOS Kliniken Germany (DE) Universität Witten/Herdecke Germany (DE) Ruhr-Universität Bochum (RUB) Germany (DE) Harzklinikum Dorothea Christiane Erxleben Germany (DE) Universitätsklinikum Freiburg Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Klinikum der Stadt Ludwigshafen am Rhein gGmbH Germany (DE) Eberhard Karls Universität Tübingen Germany (DE) Universitätsklinikum Würzburg Germany (DE)

How to cite

APA:

Wohlfeil, S.A., Kranzmann, L., Weiß, C., von Wasielewski, I., Klespe, K.C., Kähler, K.C.,... Utikal, J. (2024). Influence of adjuvant therapies on organ-specific recurrence of cutaneous melanoma: A multicenter study on 1383 patients of the prospective DeCOG registry ADOReg. International Journal of Cancer. https://doi.org/10.1002/ijc.35078

MLA:

Wohlfeil, Sebastian A., et al. "Influence of adjuvant therapies on organ-specific recurrence of cutaneous melanoma: A multicenter study on 1383 patients of the prospective DeCOG registry ADOReg." International Journal of Cancer (2024).

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