TY - JOUR
T1 - Adjuvant treatment of in-transit melanoma: Narrowing the knowledge gap left by clinical trials
AU - de Meza, M.M.
AU - Blokx, W.A.M.
AU - Bonenkamp, H.J.
AU - Blank, C.U.
AU - Aarts, M.J.B.
AU - van den Berkmortel, F.W.P.J.
AU - Boers-Sonderen, M.J.
AU - de Groot, J.W.B.
AU - Haanen, J.B.
AU - Hospers, G.A.P.
AU - Kapiteijn, E.W.
AU - van Not, O.J.
AU - Piersma, D.
AU - van Rijn, R.S.
AU - Boer, M.A.S.D.
AU - van der Veldt, A.A.M.
AU - Vreugdenhil, G.
AU - van den Eertwegh, A.J.M.
AU - Suijkerbuijk, K.P.M.
AU - Wouters, M.W.J.M.
N1 - Publisher Copyright:
© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
PY - 2023/7/15
Y1 - 2023/7/15
N2 - Few clinical trials address efficacy of adjuvant systemic treatment in patients with in-transit melanoma (ITM). This study describes adjuvant systemic therapy of ITM patients beyond clinical trials. In this study, we included stage III adjuvant-treated melanoma patients registered in the nationwide Dutch Melanoma Treatment Registry between July 2018 and December 2020. Patients were divided into three groups: nodal disease only, ITM only and ITM and nodal disease. Recurrence patterns, recurrence-free survival (RFS) and overall survival (OS) at 12-months were analyzed. In our study population of 1037 patients, 66.8% had nodal disease only, 16.7% had ITM only and 16.2% had ITM with nodal disease. RFS at 12-months was comparable in the nodal only and ITM only group (72.2% vs70.1%, P = .97) but lower in ITM and nodal disease patients (57.8%; P = .01, P < .01). Locoregional metastases occurred as first recurrence in 38.9% nodal disease only, 71.9% of ITM-only and 44.0% of ITM and nodal disease patients. Distant recurrences occurred in 42.3%, 18.8% and 36.0%, respectively (P = .02). 12-months OS was not significantly different for nodal disease only patients compared with ITM-only (94.4% vs 97.6%, P = .06) but was significantly higher for ITM-only compared with ITM and nodal disease patients (97.6% vs 91.0%, P < .01). In conclusion, we showed that in the adjuvant setting, RFS rates in ITM-only patients are similar to non-ITM, though better than in ITM and nodal disease patients. Adjuvant-treated ITM-only patients less often experience distant recurrences and have a superior OS compared with ITM and nodal disease patients.
AB - Few clinical trials address efficacy of adjuvant systemic treatment in patients with in-transit melanoma (ITM). This study describes adjuvant systemic therapy of ITM patients beyond clinical trials. In this study, we included stage III adjuvant-treated melanoma patients registered in the nationwide Dutch Melanoma Treatment Registry between July 2018 and December 2020. Patients were divided into three groups: nodal disease only, ITM only and ITM and nodal disease. Recurrence patterns, recurrence-free survival (RFS) and overall survival (OS) at 12-months were analyzed. In our study population of 1037 patients, 66.8% had nodal disease only, 16.7% had ITM only and 16.2% had ITM with nodal disease. RFS at 12-months was comparable in the nodal only and ITM only group (72.2% vs70.1%, P = .97) but lower in ITM and nodal disease patients (57.8%; P = .01, P < .01). Locoregional metastases occurred as first recurrence in 38.9% nodal disease only, 71.9% of ITM-only and 44.0% of ITM and nodal disease patients. Distant recurrences occurred in 42.3%, 18.8% and 36.0%, respectively (P = .02). 12-months OS was not significantly different for nodal disease only patients compared with ITM-only (94.4% vs 97.6%, P = .06) but was significantly higher for ITM-only compared with ITM and nodal disease patients (97.6% vs 91.0%, P < .01). In conclusion, we showed that in the adjuvant setting, RFS rates in ITM-only patients are similar to non-ITM, though better than in ITM and nodal disease patients. Adjuvant-treated ITM-only patients less often experience distant recurrences and have a superior OS compared with ITM and nodal disease patients.
KW - adjuvant treatment
KW - melanoma
KW - checkpoint inhibition therapy
KW - immunotherapy
KW - in-transit melanoma
KW - METASTASES
KW - IPILIMUMAB
KW - NIVOLUMAB
U2 - 10.1002/ijc.34485
DO - 10.1002/ijc.34485
M3 - Article
C2 - 36843260
SN - 0020-7136
VL - 153
SP - 389
EP - 398
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 2
ER -