Targeted adjuvant therapy does not improve outcomes in patients with stage III melanoma, according to a Swedish study published in the Journal of the National Cancer Institute.
Researchers found that patients with stage III melanoma had similar overall survival and melanoma-specific survival whether they were diagnosed before or after the introduction of adjuvant targeted therapies for melanoma in Sweden.
This retrospective study included all patients diagnosed with stage III melanoma in Sweden from 2016 through 2020. The patients were divided based on whether they were diagnosed before or after July 2018, which was when the European Medicines Agency approved adjuvant nivolumab and adjuvant dabrafenib and trametinib for patients with melanoma.
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Of the 1371 patients, 634 were diagnosed before approval (from January 2016 to June 2018), and 737 were diagnosed after approval (from July 2018 to December 2020).
There were no significant differences in the pre- and post-approval cohorts with regard to sex, age, site, histopathological subtype, Breslow thickness (as a continuous variable), tumor ulceration, or the number of lymph node metastases.
However, the pre-approval cohort had thinner melanomas (as a categorical variable, P =.002), had more in transit/satellite metastasis (P =.011), and were more likely to have stage IIIA melanoma (P =.020).
The median follow-up was 57 months in the pre-approval cohort and 27 months in the post-approval cohort.
The 2-year melanoma-specific survival rate was 87.0% in the pre-approval cohort and 88.9% in the post-approval cohort (hazard ratio [HR], 0.92; 95% CI, 0.69-1.24; P =.60).
The 2-year overall survival rate was 84.3% in the pre-approval cohort and 86.1% in the post-approval cohort (HR, 0.93; 95% CI, 0.72-1.21; P =.60).
After the researchers adjusted for age, sex, and AJCC stage, there was still no significant difference between the pre- and post-approval cohorts for melanoma-specific survival (HR, 0.92; 95% CI, 0.69-1.24; P =.59) or overall survival (HR, 0.91; 95% CI, 0.70-1.19; P =.51).
In addition, there were no significant differences in melanoma-specific survival or overall survival between the pre- and post-approval cohorts across any of the subgroups analyzed.
“To summarize the findings from Sweden, no improvement in survival can be detected after the introduction of adjuvant melanoma treatment in 2018,” the researchers wrote. “While overall data from the EORTC 1325/KEYNOTE-054 study is still awaited, we believe that this finding is of potential interest to the melanoma community.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Helgadottir H, Ny L, Ullenhag GJ, et al. Survival after introduction of adjuvant treatment in stage III melanoma: A nationwide registry-based study. J Natl Cancer Inst. Published online May 25, 2023. doi:10.1093/jnci/djad081
This article originally appeared on Cancer Therapy Advisor
