Melanoma recurrence patterns and management after adjuvant targeted therapy: a multicentre analysis

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.