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Updated: Dec 4, 2025
A 3D Organotypic Melanoma Spheroid Skin Model
Published on: May 18, 2018
Melanoma recurrence patterns and management after adjuvant targeted therapy: a multicentre analysis
Prachi Bhave1, Lalit Pallan2, Georgina V Long2,3
1Department of Medical Oncology, Alfred Hospital, Melbourne, VIC, Australia. Prachi_Bhave@yahoo.com.
Background:
Adjuvant targeted therapy (TT) improves relapse free survival in patients with resected BRAF mutant stage III melanoma. The outcomes and optimal management of patients who relapse after adjuvant TT is unknown.
Methods:
Patients from twenty-one centres with recurrent melanoma after adjuvant TT were included. Disease characteristics, adjuvant therapy, recurrence, treatment at relapse and outcomes were examined.
Results:
Eighty-five patients developed recurrent melanoma; nineteen (22%) during adjuvant TT. Median time to first recurrence was 18 months and median follow-up from first recurrence was 31 months. Fifty-eight (68%) patients received immunotherapy (IT) or TT as 1st line systemic therapy at either first or subsequent recurrence and had disease that was assessable for response. Response to anti-PD-1 (±trial agent), combination ipilimumab-nivolumab, TT rechallenge and ipilimumab monotherapy was 63%, 62% 25% and 10% respectively. Twenty-eight (33%) patients had died at census, all from melanoma. Two-year OS was 84% for anti-PD-1 therapy (±trial agent), 92% for combination ipilimumab and nivolumab, 49% for TT and 45% for ipilimumab monotherapy (p = 0.028).
Conclusions:
Patients who relapse after adjuvant TT respond well to subsequent anti-PD-1 based therapy and have outcomes similar to those seen when first line anti-PD-1 therapy is used in stage IV melanoma.
Insights
Patients with BRAF-mutant melanoma relapsing after targeted therapy (TT) show good responses to anti-PD-1 immunotherapy. These outcomes are comparable to initial anti-PD-1 use in stage IV melanoma patients.
Area of Science:
- Oncology
- Dermatology
- Melanoma Research
Background:
- Adjuvant targeted therapy (TT) enhances relapse-free survival in resected BRAF-mutant stage III melanoma.
- Optimal management strategies for patients experiencing recurrence after adjuvant TT remain unclear.
Purpose of the Study:
- To investigate the outcomes and treatment responses of patients with recurrent melanoma following adjuvant targeted therapy.
- To evaluate the effectiveness of different systemic therapies, including immunotherapy and targeted therapy rechallenge, in this patient population.
Main Methods:
- A multi-center study included 85 patients with recurrent melanoma after adjuvant TT.
- Data collected included disease characteristics, adjuvant therapy details, recurrence patterns, and treatments received at relapse.
- Treatment responses and overall survival (OS) were analyzed for various systemic therapies.
Main Results:
- Nineteen patients (22%) recurred during adjuvant TT, with a median time to recurrence of 18 months.
- Among 58 patients receiving immunotherapy (IT) or TT as first-line therapy at recurrence, response rates were 63% for anti-PD-1 (± trial agent) and 62% for ipilimumab-nivolumab.
- Two-year OS rates were significantly higher for anti-PD-1 based therapies (84-92%) compared to TT rechallenge (49%) or ipilimumab monotherapy (45%).
Conclusions:
- Patients relapsing after adjuvant TT demonstrate favorable responses to subsequent anti-PD-1 based therapies.
- Outcomes in this setting appear similar to those observed with first-line anti-PD-1 therapy in stage IV melanoma.
- Anti-PD-1 immunotherapy represents an effective treatment option for BRAF-mutant melanoma patients post-adjuvant TT.
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