% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Lodde:277779, author = {G. C. Lodde and J. Hassel and L. M. Wulfken and F. Meier and P. Mohr and K. Kähler and A. Hauschild and B. Schilling and C. Loquai and C. Berking and S. Hüning and J. Eckardt and R. Gutzmer and L. Reinhardt and V. Glutsch and U. Nikfarjam and M. Erdmann and C. L. Beckmann and A. Stang and B. Kowall and W. Galetzka and A. Roesch$^*$ and S. Ugurel$^*$ and L. Zimmer and D. Schadendorf$^*$ and A. Forschner and E. Livingstone}, title = {{A}djuvant treatment and outcome of stage {III} melanoma patients: {R}esults of a multicenter real-world {G}erman {D}ermatologic {C}ooperative {O}ncology {G}roup ({D}e{COG}) study.}, journal = {European journal of cancer}, volume = {191}, issn = {0014-2964}, address = {Amsterdam [u.a.]}, publisher = {Elsevier}, reportid = {DKFZ-2023-01494}, pages = {112957}, year = {2023}, abstract = {Clinical trials demonstrated significantly improved recurrence-free survival (RFS) of melanoma patients receiving adjuvant treatment. As data from controlled trials are based on selected populations, we investigated adjuvantly treated stage III melanoma patients under real-world conditions.In a prior multicenter cohort study, stage III-IV melanoma patients were analysed for their choice of adjuvant therapy. In this follow-up study, we examined RFS, overall and melanoma-specific survival (MSS) and response to the subsequent treatment of 589 stage III patients (232 BRAF-mutated) receiving adjuvant PD-1 inhibitors (PD1; n = 479) or targeted therapy (TT; n = 110).The median follow-up of the total cohort was 25.7 months. The main reason for premature discontinuation of adjuvant therapy was disease progression in PD1- $(28.8\%,$ n = 138/479) and adverse events in TT-treated patients $(28.2\%,$ n = 31/110). Among BRAF-mutated patients, RFS at 24 months was $49\%$ $(95\%$ CI $40.6-59.0\%)$ for PD1- and $67\%$ $(95\%$ CI $58-77\%)$ for TT-treated patients. The risk of recurrence was higher for BRAF-mutated PD1 than TT (hazard ratio 1.99; $95\%$ CI 1.34-2.96; hazard ratio adjusted for age, sex and tumour stage, 2.21; $95\%$ CI 1.48-3.30). Twenty-four months MSS was $87\%$ $(95\%$ CI 81.0-94.1) for PD1 and $92\%$ $(95\%$ CI 86.6-97.0) for TT. Response to subsequent systemic treatment for unresectable disease was $22\%$ for all PD1- and $16\%$ for TT-treated patients.PD1-treated patients had more and earlier recurrences than TT patients. In BRAF-mutated patients, adjuvant TT might prevent early recurrences more effectively than PD1 treatment. Management of recurrence despite adjuvant treatment is challenging, with low response to current therapeutic options.The datasets generated during and/or analysed during the current study are available for qualified researchers from the corresponding authors upon request.}, keywords = {Adjuvant treatment (Other) / BRAF (Other) / Immunotherapy (Other) / Melanoma (Other) / PD1 (Other) / Real-world (Other) / Targeted therapy (Other)}, cin = {ED01}, ddc = {610}, cid = {I:(DE-He78)ED01-20160331}, pnm = {899 - ohne Topic (POF4-899)}, pid = {G:(DE-HGF)POF4-899}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:37487400}, doi = {10.1016/j.ejca.2023.112957}, url = {https://inrepo02.dkfz.de/record/277779}, }