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@ARTICLE{Khler:302826,
author = {K. C. Kähler and J. C. Hassel and M. Ziemer and P.
Rutkowski and F. Meier and L. Flatz and C. Gaudy-Marqueste
and L. Zimmer$^*$ and M. Santinami and F. Russano and I. von
Wasielewski and T. K. Eigentler and M. Maio and I. Zalaudek
and S. Haferkamp and P. Quaglino and J. Welzel and C.
Röcken and A. Enk and J.-C. Simon and T. Świtaj and M.
Garzarolli and T. Amaral and N. Malissen and E.
Livingstone$^*$ and G. Elia and A. Covelli and K. Lorizzo
and D. Neri and S. Mulatto and A. Parca and B. Pizzichi and
P. A. Ascierto and C. Garbe and C. Robert and D.
Schadendorf$^*$ and A. Hauschild},
title = {{N}eoadjuvant {I}ntralesional {T}argeted {I}mmunocytokines
({D}aromun) in {S}tage {III} {M}elanoma.},
journal = {Annals of oncology},
volume = {nn},
issn = {0923-7534},
address = {Amsterdam [u.a.]},
publisher = {Elsevier},
reportid = {DKFZ-2025-01366},
pages = {nn},
year = {2025},
note = {epub},
abstract = {This phase 3 trial assessed daromun, a combination of two
fibronectin-targeting immunocytokines (L19IL2 and L19TNF),
as a neoadjuvant treatment for patients with clinically
detectable stage IIIB/C melanoma (AJCC version 7).Patients
were randomized to 4 weekly intralesional daromun
administrations (13 Mio IU of L19IL2 and 400 μg of L19TNF)
followed by surgery, or upfront surgery. Pretreatment with
approved adjuvant agents was allowed. The primary endpoint
was recurrence-free survival (RFS): events were disease
recurrence or death from any cause after complete surgical
tumor resection.246 patients were randomized and included in
the intention-to-treat analysis: $74\%$ had undergone ≥ 2
prior surgical resections and $35\%$ had received prior
systemic therapy. At a median follow-up of 21 months, the
neoadjuvant group (N=122) had a significantly longer RFS
than the upfront surgery group (N=124), with a median RFS of
16.7 and 6.8 months, respectively (HR 0.59; $95\%$ CI 0.41
to 0.86, p=0.005, log-rank test). The risk of distant
recurrence was reduced by $40\%$ in the neoadjuvant arm
(HR=0.60; $95\%$ CI [0.37; 0.95]; p=0.029). Grade ≥ 3
treatment-related adverse events (TRAEs) were $6.7\%$ in the
surgery alone arm and $27.1\%$ in the daromun arm, mostly
injection site reactions.Neoadjuvant daromun resulted in a
significantly longer RFS than upfront surgery in patients
with locally advanced melanoma. TRAEs were transient and
manageable. Neoadjuvant daromun is a new therapeutic option
for patients with stage III melanoma, including those with
locoregional recurrence after surgery and previous adjuvant
therapy.},
keywords = {Neoadjuvant (Other) / immunotherapy (Other) / intralesional
(Other) / locally advanced (Other) / melanoma (Other) /
resectable (Other) / targeted immunocytokines (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:40633690},
doi = {10.1016/j.annonc.2025.06.014},
url = {https://inrepo02.dkfz.de/record/302826},
}