TY - JOUR
T1 - Melanoma recurrence patterns and management after adjuvant targeted therapy
T2 - a multicentre analysis
AU - Bhave, Prachi
AU - Pallan, Lalit
AU - Long, Georgina V.
AU - Menzies, Alexander M.
AU - Atkinson, Victoria
AU - Cohen, Justine V.
AU - Sullivan, Ryan J.
AU - Chiarion-Sileni, Vanna
AU - Nyakas, Marta
AU - Kahler, Katharina
AU - Hauschild, Axel
AU - Plummer, Ruth
AU - Trojaniello, Claudia
AU - Ascierto, Paolo A.
AU - Zimmer, Lisa
AU - Schadendorf, Dirk
AU - Allayous, Clara
AU - Lebbe, Celeste
AU - Maurichi, Andrea
AU - Santinami, Mario
AU - Roy, Severine
AU - Robert, Caroline
AU - Lesimple, Thierry
AU - Patel, Sapna
AU - Versluis, Judith M.
AU - Blank, Christian U.
AU - Khattak, Adnan
AU - Van der Westhuizen, Andre
AU - Carlino, Matteo S.
AU - Shackleton, Mark
AU - Haydon, Andrew
N1 - Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Cancer Research UK.
PY - 2021/2/2
Y1 - 2021/2/2
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85093090624&partnerID=8YFLogxK
U2 - 10.1038/s41416-020-01121-y
DO - 10.1038/s41416-020-01121-y
M3 - Article
C2 - 33087895
AN - SCOPUS:85093090624
SN - 0007-0920
VL - 124
SP - 574
EP - 580
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 3
ER -