Multicenter analysis of melanoma recurrence pattern and management after adjuvant immunotherapy.

• DOI: 10.1200/jco.2023.41.16_suppl.e21573
• Publication Date: 2023-06-04T16:25:01Z
• Authors: Sergio Martínez R...; Maria Alejandra M...; Eva Muñoz-Couselo; Alberto Rafael Se...; Juan Martin-Liberal; Mayra Orrillo; Luis Antonio Fern...; Maria Quindós Varela; Rocio Lesta; Andrés Barba; Ivana Sullivan; Margarita Majem
• Keywords: Breslow Thickness; Adjuvant Therapy; Univariate analysis

e21573 Background: PD-1 inhibitors improve outcomes in resected stage II-IV melanoma. However, recurrence patterns and prognostic factors are less known. Methods: We conducted a retrospective study melanoma patients (p) treated with adjuvant (clinical practice or clinical trials) from 5 centers. Demographic, disease characteristics, therapy, recurrence, treatment at relapse outcome were recorded. Descriptive assessment for analysis performed. Results: From June 2017 to 2022, 181 p included. Median age was 59 years [22-81], 57% male, 85% had cutaneous melanoma, 28% BRAF V600E mutation. 9 (5%) presented II, 147 (81%) III 25 (14%) IV. Ulceration present 59% p, mitotic rate >1/mm 2 84%, Breslow index >3 mm 65% elevated LDH 51%. 81% received alone 19% combination other immunotherapies. 52% of completed treatment, 12% discontinued due toxicity 26% relapse. 13% grade 3-4 adverse events there myocarditis. With median follow-up 18,1 months, 68 (37%) recurred (Table). free survival (RFS) 48,8 months (95% CI 31,1-66,4). Recurrence significantly associated higher stage, rate, level index, mutation, non-cutaneous delayed initiation immunotherapy univariate (p<0,05). Stage, (16% p) multivariate (<0,05). Locoregional 23 surgery (14p), + RT (7p) (2). Systemic 50 p: all mutant targeted therapy (24p, 43%) control (DCR) 91% progression (PFS) 56 24,1-NR); wild type (26p, 47%) anti-PD-1 (9p) (7p), anti-CTLA-4 (2p), chemotherapy (1p) best supportive care DCR 33% PFS 8 6,9-10,8). Conclusions: observed 37% systemic more frequent than locoregional recurrence. Treatment achieved p; better previously reported.[Table: see text]