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@ARTICLE{Zimmermann:307460,
author = {N. Zimmermann and J. Kött and T. Zell and A. Z. Abedini
and C. L. Blomen and S. Belz and B. Deitert and I. Heidrich
and G. Geidel and A. Rünger and D. J. Smit and M.
Weichenthal and S. Ugurel and U. Leiter and C. Berking and
R. Gutzmer and D. Schadendorf$^*$ and I. von Wasielewski and
P. Mohr and F. Meier and R. Herbst and J. Utikal$^*$ and P.
Terheyden and S. Haferkamp and C. Pföhler and M. Kaatz and
F. Ziller and J. Ulrich and F. Meiss and A. T. Bauer and S.
W. Schneider and C. Gebhardt},
title = {{E}nhanced overall and progression-free survival in
advanced melanoma patients undergoing targeted therapy
alongside antithrombotic treatment - {I}nsights from a
multicenter study involving 1296 patients from the
prospective skin cancer registry {ADOR}eg.},
journal = {European journal of cancer},
volume = {234},
issn = {0959-8049},
address = {Amsterdam [u.a.]},
publisher = {Elsevier},
reportid = {DKFZ-2025-03059},
pages = {116195},
year = {2026},
note = {2025 Dec 19:234:116195 / Available online 19 December 2025},
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.},
keywords = {Anticoagulation (Other) / Melanoma (Other) / Targeted
therapy (Other)},
cin = {ED01 / A370},
ddc = {610},
cid = {I:(DE-He78)ED01-20160331 / I:(DE-He78)A370-20160331},
pnm = {311 - Zellbiologie und Tumorbiologie (POF4-311)},
pid = {G:(DE-HGF)POF4-311},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41448065},
doi = {10.1016/j.ejca.2025.116195},
url = {https://inrepo02.dkfz.de/record/307460},
}