Distinct Recurrence Patterns Seen for Primary, Relapsed Cutaneous Melanoma

Significantly lower progression-free survival, reduced distant metastasis-free survival seen for BRAF-mutated CM with immune checkpoint inhibitor
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Medically Reviewed By:
Meeta Shah, M.D.

WEDNESDAY, July 10, 2024 (HealthDay News) -- Primary and relapsed cutaneous melanoma (CM) have distinct patterns of recurrence, according to a study published online July 8 in the International Journal of Cancer.

Sebastian A. Wohlfeil, M.D., from Heidelberg University in Mannheim, Germany, and colleagues extracted data for patients with primary or relapsed CM (1,033 and 350, respectively) who received adjuvant therapies with nivolumab (N), pembrolizumab (P), or dabrafenib and trametinib (D + T) to examine whether adjuvant treatments influence patterns of recurrence. Progression-free survival (PFS), distant metastasis-free survival (DMFS), organ-specific DMFS, and overall survival (OS) were examined as end points.

The researchers found that D + T indicated an improved PFS compared with P or N for primary cases (one-year PFS: 90.9 percent versus 81.0 and 83.8 percent, respectively; two-year PFS: 82.7 percent versus 73.9 and 75.2 percent, respectively). Significantly lower PFS and reduced DMFS were seen with immune checkpoint inhibitor (ICI) treatment instead of D + T for BRAF-mutated (mut) CM. NRAS-mut CM tended to perform worse than wild-type CM with ICI treatment; similar OS was seen between the groups. Compared with primary cases, relapsed cases showed reduced PFS, DMFS, and OS; no significant differences were seen between the subgroups. Increased recurrence was seen in primary and relapsed cases in NRAS-mut CM.

"These data show that adjuvant targeted therapy is superior to ICI in primary, BRAF-mut CM," the authors write. "Besides, NRAS-mut CM should be carefully monitored during adjuvant therapy, since these demonstrated increased melanoma recurrence in both primary and relapsed cases."

Several authors disclosed financial ties to the pharmaceutical industry.

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