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ORIGINAL RESEARCH ARTICLE

Adjuvant immunotherapy in high-risk resectable melanoma: A real-world experience

Mohammad Usman Hakeem1† ,  Gabriela Marsavela2 ,  Afaf Abed3,4,5 ,  Muhammad Adnan Khattak2,4†*
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1 Department of Medical Oncology, Linear Clinical Research Institute, Nedlands, Western Australia, Australia
2 Department of Medical Oncology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
3 Department of Medical Oncology, Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
4 Department of Medical Oncology, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
5 Department of Medical Oncology, School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
Tumor Discovery 2024, 3(3), 3143 https://doi.org/10.36922/td.3143
Submitted: 11 March 2024 | Accepted: 19 June 2024 | Published: 2 August 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Adjuvant immunotherapy with nivolumab or pembrolizumab represents the current standard of care for resected high-risk Stage III and IV malignant melanoma. However, data on its real-world outcomes and efficacy beyond clinical trials are limited. We evaluated the data of high-risk Stage III and IV melanoma patients treated with adjuvant immunotherapy in two hospitals in Western Australia, Australia. The study involved the retrospective collection and analysis of data from 95 eligible patients treated with nivolumab or pembrolizumab. These patients were planned to receive 1 year of immunotherapy, with treatment continuing until disease recurrence, unacceptable toxicity, or voluntary withdrawal. Our evaluation focused on overall survival (OS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS), along with safety outcomes. The findings of our study indicated a 2-year RFS of 73%, a DMFS of 73%, and an OS of 94%. Treatment-related adverse events were observed in 63.1% of patients, with cutaneous manifestations being the most common treatment-related toxicity and gastrointestinal tract issues being the most common higher-grade immune-related adverse event. Importantly, these findings do not significantly differ from the landmark clinical trials, CheckMate-238 and KEYNOTE-054. In conclusion, adjuvant immune checkpoint inhibitor therapy administered for up to 1 year in high-risk Stage III and IV melanoma demonstrates a comparable efficacy and toxicity profile in real-world settings to that observed in the pivotal trials.

Keywords
High-risk melanoma
Resectable
Real-world data
Adjuvant
Immunotherapy
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Tumor Discovery, Electronic ISSN: 2810-9775 Print ISSN: 3060-8597, Published by AccScience Publishing
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