Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Bhave P

PROVIDER: S-EPMC7851118 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Bhave Prachi P Pallan Lalit L Long Georgina V GV Menzies Alexander M AM Atkinson Victoria V Cohen Justine V JV Sullivan Ryan J RJ Chiarion-Sileni Vanna V Nyakas Marta M Kahler Katharina K Hauschild Axel A Plummer Ruth R Trojaniello Claudia C Ascierto Paolo A PA Zimmer Lisa L Schadendorf Dirk D Allayous Clara C Lebbe Celeste C Maurichi Andrea A Santinami Mario M Roy Severine S Robert Caroline C Lesimple Thierry T Patel Sapna S Versluis Judith M JM Blank Christian U CU Khattak Adnan A Van der Westhuizen Andre A Carlino Matteo S MS Shackleton Mark M Haydon Andrew A

British journal of cancer 20201022 3

<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>Eighty-five patients developed recurrent melano ...[more]

PMID: 33087895

Similar Datasets

Project description:BackgroundAnti-programmed cell death protein 1 (PD-1) antibodies (PD1) prolong recurrence-free survival in high-risk resected melanoma; however, approximately 25%-30% of patients recur within 1 year. This study describes the pattern of recurrence, management and outcomes of patients who recur with adjuvant PD1 therapy.Patients and methodsConsecutive patients from 16 centres who recurred having received adjuvant PD1 therapy for resected stage III/IV melanoma were studied. Recurrence characteristics, management and outcomes were examined; patients with mucosal melanoma were analysed separately.ResultsMelanoma recurrence occurred in 147 (17%) of ∼850 patients treated with adjuvant PD1. In those with cutaneous melanoma (n = 136), median time to recurrence was 4.6 months (range 0.3-35.7); 104 (76%) recurred during (ON) adjuvant PD1 after a median 3.2 months and 32 (24%) following (OFF) treatment cessation after a median 12.5 months, including in 21 (15%) who ceased early for toxicity. Fifty-nine (43%) recurred with locoregional disease only and 77 (57%) with distant disease. Of those who recurred locally, 22/59 (37%) subsequently recurred distantly. Eighty-nine (65%) patients received systemic therapy after recurrence. Of those who recurred ON adjuvant PD1, none (0/6) responded to PD1 alone; 8/33 assessable patients (24%) responded to ipilimumab (alone or in combination with PD1) and 18/23 (78%) responded to BRAF/MEK inhibitors. Of those who recurred OFF adjuvant PD1, two out of five (40%) responded to PD1 monotherapy, two out of five (40%) responded to ipilimumab-based therapy and 9/10 (90%) responded to BRAF/MEK inhibitors.ConclusionsMost patients who recur early despite adjuvant PD1 develop distant metastases. In those who recur ON adjuvant PD1, there is minimal activity of further PD1 monotherapy, but ipilimumab (alone or in combination with PD1) and BRAF/MEK inhibitors have clinical utility. Retreatment with PD1 may have activity in select patients who recur OFF PD1.

Dataset Information

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

Background

Methods

Results

Conclusions

Publications

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

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets