Journal Article

DKFZ-2025-03059

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Enhanced overall and progression-free survival in advanced melanoma patients undergoing targeted therapy alongside antithrombotic treatment - Insights from a multicenter study involving 1296 patients from the prospective skin cancer registry ADOReg.

Zimmermann, N. ; Kött, J. ; Zell, T. ; Abedini, A. Z. ; Blomen, C. L. ; Belz, S. ; Deitert, B. ; Heidrich, I. ; Geidel, G. ; Rünger, A. ; Smit, D. J. ; Weichenthal, M. ; Ugurel, S. ; Leiter, U. ; Berking, C. ; Gutzmer, R. ; Schadendorf, D.DKFZ* ; von Wasielewski, I. ; Mohr, P. ; Meier, F. ; Herbst, R. ; Utikal, J.DKFZ* ; Terheyden, P. ; Haferkamp, S. ; Pföhler, C. ; Kaatz, M. ; Ziller, F. ; Ulrich, J. ; Meiss, F. ; Bauer, A. T. ; Schneider, S. W. ; Gebhardt, C.

2026
Elsevier Amsterdam [u.a.]

Abstract: Targeted therapies (TT) improve outcomes in BRAF-mutant melanoma. Pre-clinical data suggest that anticoagulation (AC) and platelet aggregation inhibition (PAI) may have antitumoral effects. We evaluated the impact of concomitant AC or PAI on outcomes in patients receiving TT.We analyzed 1296 patients with unresectable stage III-IV BRAF-mutant melanoma treated with BRAF plus MEK inhibitors (2016-2024) in the prospective multicenter ADOReg registry. Patients were categorized as receiving no antithrombotic therapy (ATT; n = 1125), PAI (n = 73; acetylsalicylic acid or clopidogrel), or AC (n = 98; direct oral anticoagulants, low-molecular-weight heparin, or vitamin K antagonists).Median follow-up was 1.3 years. Compared with patients without ATT, those receiving AC had significantly improved 12-month progression-free survival (PFS; HR 0.55, 95 % CI 0.39-0.78, p = 0.001) and overall survival (OS; HR 0.35, 95 % CI 0.19-0.64, p = 0.001). Direct oral anticoagulants showed the most pronounced PFS benefit (HR 0.40, 95 % CI 0.25-0.64, p < 0.001). PAI was not associated with a significant difference in PFS, but multivariable Cox regression indicated a reduced hazard of death (HR 0.48, 95 % CI 0.27-0.87, p = 0.015).Concomitant AC, particularly factor Xa-inhibiting direct oral anticoagulants, was associated with improved survival in melanoma patients undergoing TT. These findings support prospective trials evaluating AC as concomitant therapy in advanced melanoma.

Keyword(s): Anticoagulation ; Melanoma ; Targeted therapy

Note: 2025 Dec 19:234:116195 / Available online 19 December 2025

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Essen/Düsseldorf (ED01)
2. KKE Dermatoonkologie (A370)

Research Program(s):

1. 311 - Zellbiologie und Tumorbiologie (POF4-311) (POF4-311)

Appears in the scientific report 2025

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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