Journal Article

Three-Year Analysis of Adjuvant Therapy in Postoperative Melanoma including Acral and Mucosal Subtypes

Asano, Yoshihide, Fujimura, Taku, Matsushita, Shigeto, Ohuchi, Kentaro, Muto, Yusuke, Kato, Hiroshi, Hashimoto, Akira, Ito, Takamichi, Ishizuki, Shoichiro, Fukushima, Satoshi, Mizuhashi, Satoru, Amagai, Ryo, Kambayashi, Yumi, Maekawa, Takeo, Yamamoto, Yuki, Fujisawa, Yasuhiro, Yoshino, Koji, Uchi, Hiroshi

2024

Overview

Background: Adjuvant therapy has improved the clinical prognosis for postoperative melanoma patients. However, the long-term efficacy of this therapy on the melanoma acral and mucosal subtypes has not been fully evaluated in previous trials. This study assessed the 3-year recurrence-free survival and overall survival of patients with melanoma, including the acral and mucosal subtypes, treated with anti-PD-1 antibody (Ab) or with the combination of the BRAF and MEK inhibitors dabrafenib and trametinib. Methods: We retrospectively analyzed both the 3-year time to relapse (TTR) and overall survival (OS) of 120 patients treated with anti-PD-1 antibody (Ab), or with the combination of dabrafenib and trametinib. Results: The overall median TTR was 18.4 months, with a range of 0.69 to 36 months. The 3-year TTR of the acral and mucosal types was 28.1% and 38.5%, respectively. Baseline tumor thickness (TT) and acral type were associated with the TTR in subgroup analysis. Moreover, we classified 104 acral and non-acral cutaneous patients into the anti-PD-1 Abs or dabrafenib plus trametinib combined therapies cohort in multiple analyses. The acral subtype and TT were detected as important prognostic factors. In the 3-year OS, only tumor ulceration was associated with the OS in both univariate and multiple analyses. There was no significant difference in baseline or treatment-related factors of the mucosal type (p > 0.05). Conclusion: This study suggests that adjuvant therapy is more effective with non-acral cutaneous melanoma than either the acral or mucosal types at the 3-year TTR endpoint.

• Publisher: MDPI AG
• Subject: Adjuvant therapy / Adjuvants / Antigens / Antimitotic agents / Antineoplastic agents / Apoptosis / Cancer / Care and treatment / Clinical trials / Ethics / Lymphatic system / Medical colleges / Medical prognosis / MEK inhibitors / Melanoma / Mucosa / Multivariate analysis / Patients / PD-1 protein / Survival / Toxicity / Tumors