@article{ba9cce4c4c544d1bbc0880313b5bc19d,
title = "Surgery for Unresectable Stage IIIC and IV Melanoma in the Era of New Systemic Therapy",
abstract = "Opportunities for surgical treatment in metastatic melanoma patients have re-emerged due to the development of novel systemic therapeutics over the past decade. The aim of this study is to present data on outcomes of surgery in patients with unresectable stage IIIC and IV melanoma, who have previously been treated with immunotherapy or targeted therapy. Data was extracted from the Dutch Melanoma Treatment Registry (DMTR) on 154 patients obtaining disease control to systemic therapy and undergoing subsequent surgery. Disease control was defined as a complete response (CR), which was seen in 3.2% of patients; a partial response (PR), seen in 46.1% of patients; or stable disease (SD), seen in 44.2% of patients. At a median follow-up of 10.0 months (interquartile range 4-22) after surgery, the median overall survival (OS) had not been reached in our cohort and median progression-free survival (PFS) was 9.0 months (95% CI 6.3-11.7). A CR or PR at first follow-up after surgery was associated with both a better OS and PFS compared to stable or progressive disease (p < 0.001). We conclude that selected patients can benefit from surgery after achieving disease control with systemic therapy.",
keywords = "braf, combined nivolumab, dabrafenib, double-blind, dutch melanoma treatment registry, ipilimumab, metastatic melanoma, multicenter, open-label, phase-3, surgery, survival, systemic therapy, SURVIVAL, DABRAFENIB, MULTICENTER, COMBINED NIVOLUMAB, OPEN-LABEL, BRAF, PHASE-3, METASTATIC MELANOMA, DOUBLE-BLIND, Dutch Melanoma Treatment Registry, IPILIMUMAB",
author = "S.A. Blankenstein and M.J.B. Aarts and {van den Berkmortel}, F.W.P.J. and M.J. Boers-Sonderen and {van den Eertwegh}, A.J.M. and M.G. Franken and {de Groot}, J.W.B. and J.B.A.G. Haanen and G.A.P. Hospers and E. Kapiteijn and D. Piersma and {van Rijn}, R.S. and K.P.M. Suijkerbuijk and {ten Tije}, A.J. and {van der Veldt}, A.A.M. and G. Vreugdenhil and M.W.J.M. Wouters and {van Akkooi}, A.C.J.",
note = "Funding Information: Funding: This research was funded by The Netherlands Organization for Health Research and Development (ZonMW), grant number 836002002. This subsidy is part of the program of effectiveness research of high-cost medicine. The first four years (2012–2016) of the Dutch Melanoma Treatment Registry (DMTR) were sponsored by Roche Nederland B.V, Bristol-Myers Squibb (BMS), GlaxoSmithKline (GSK)/Novartis and, since 2015, also by Merck Sharp & Dohme (MSD). Funding Information: Conflicts of Interest: M.J.B.A. has consulting/advisory relationships with BMS, MSD, Merck, Pfizer, Pierre Fabre, Roche, Ipsen, Novartis, Astellas and Sanofi. M.J.B.-S. has consulting/advisory relationships with BMS, Pierre Fabre and Novartis. A.J.M.v.d.E. has consulting/advisory relationships with BMS, Roche, MSD Oncology, Amgen, Sanofi, Pfizer, Ipsen, Merck, Pierre Fabre and Novartis. He received a study grant from Sanofi, Roche and BMS. He received travel expenses from MSD Oncology, Roche, Pfizer and Sanofi. He received speaker honoraria from BMS and Novartis. M.G.F. received study grants form Abbvie, Daiichi Sankyo, PamGene, Gilead Sciences Netherlands B.V., Roche Nederland B.V. J.W.B.d.G. has consulting/advisory relationships with BMS, MSD, Novartis, Pierre Fabre and Servier. J.B.A.G.H. has provided consultation, attended advisory boards, and/or provided lectures for: Amgen, AZ, Bayer, BMS, Celsius Therapeutics, GSK, Ipsen, Merck Serono, MSD, Novartis, Pfizer, Roche/Genentech, Sanofi, Seattle Genetics, AIMM, Neogene Therapeutics, Gadeta, Immunocore, Vaximm, and Neon Therapeutics and received grant support from, BMS, MSD, Novartis, Neon Therapeutics. G.A.P.H. has consulting/advisory relationships with Amgen, Roche, MSD, BMS, Pfizer, Novartis and received research grants from BMS and Seerave. E.K. has consulting/advisory relationships with Amgen, Bristol-Myers Squibb, Novartis, Roche, Merck, Pierre-Fabre, EISAI, Bayer, Genzyme-Sanofi and received research grants from Novartis and Bristol-Myers Squibb. K.P.M.S. has consulting/advisory relationships with BMS, MSD, Novartis, Pierre Fabre and Roche. A.A.M.v.d.V. has consulting/advisory relationships with BMS, MSD, Merck, Pfizer, Pierre Fabre, Roche, Eisai, Ipsen and Novartis. A.C.J.v.A. has consulting/advisory relationships with Amgen, BMS, MSD-Merck, Merck-Pfizer, Novartis, 4SC and Sanofi and has received research funding from Amgen, BMS and Novartis. The other authors report no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Publisher Copyright: {\textcopyright} 2020 by the authors. Licensee MDPI, Basel, Switzerland.",
year = "2020",
month = may,
day = "1",
doi = "10.3390/cancers12051176",
language = "English",
volume = "12",
journal = "Cancers",
issn = "2072-6694",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "5",
}