Survival impact of adjuvant treatment in resected stage III cutaneous melanoma patients: Results from a real-life cohort study (TAMARIS).
Year: 2025
Type: conference-abstract
Abstract: 9576 Background: Anti-PD-1 immunotherapies and BRAF+MEK inhibitors (BRAFi/MEKi) (specifically for BRAF V600E/K-mutant melanoma) have been shown to improve recurrence-free survival (RFS) in patients (pts) with resected stage III metastatic melanoma in phase III trials. However, none of these studies has demonstrated a significant improvement in overall survival (OS). Notably, adjuvant BRAFi/MEKi therapy has shown better OS only in the BRAF V600E subgroup of patients. In this context, we evaluated the real-world impact of adjuvant therapies on OS. Methods: TAMARIS is a national multicenter retrospective study designed to evaluate the efficacy of adjuvant treatment (anti-PD-1 or BRAFi/MEKi) in pts with resected AJCC 8 th edition stage III melanoma using data from the French RIC-Mel prospective database. The primary endpoint was OS analyzed using the Kaplan-Meier method, comparing pts who received adjuvant treatment (adjuvant group) within 3 months of surgery to those who did not (control group). Demographic and clinical characteristics were compared using chi-square analyses. Secondary endpoints included OS in specific subgroups and RFS. Results: A total of 1,172 pts (median age: 65 years [IQR: 53–74]) with resected stage III melanoma were included between 2018 and 2023. Among them, 796 pts (68%) received adjuvant treatment with anti-PD-1 (n=676) or BRAFi/MEKi (n=120). The median treatment duration was 10.8 months (IQR: 5.6–11.9). Most pts had a history of SSM (54%) with a median Breslow thickness of 2.8 mm [range, 0-47] and stage IIIB (31%) or IIIC disease (49%). Surgical interventions for metastases prior to adjuvant treatment included lymph node dissection in 53% of cases, sentinel lymph node biopsy in 38%, and cutaneous metastasis resection in 8%. Pts in the control group were older (median age: 69.7 vs. 63.0 years, p < 0.0001). The median follow-up was 30.4 months (IQR: 16.7-43.3). OS was significantly longer in the adjuvant group compared to the control group (HR: 0.617; 95% CI: 0.474-0.802; p = 0.0003), with a 2-year OS of 90% (95% CI: 88-92) in the adjuvant group versus 79% (95% CI: 74-83) in the control group. There was a trend toward better OS with BRAFi/MEKi compared to anti-PD-1 (HR: 0.569; 95% CI: 0.312-1.037; p = 0.065). Subgroup analyses demonstrated a significant positive impact of adjuvant treatment on OS across most subgroups, except for pts aged ≤75 years, those with stage IIIA disease, primary melanomas with a Breslow thickness <2.8 mm, or without ulceration. RFS also favored the adjuvant group (HR: 0.545; 95% CI: 0.458-0.649; p < 0.0001), with a 2-year RFS of 67% (95% CI: 63-70) and 45% (95% CI: 40-50) in the control group. Conclusions: Adjuvant treatment appears to provide an OS benefit in patients with resected stage III melanoma in real-world settings. Further research is required as age-related differences may influence prognosis.
Source: Journal of Clinical Oncology
Institutions: Inserm, Interactions Hôte-Greffon-Tumeur & Ingénierie Cellulaire et Génique, Université de Franche-Comté, Centre Hospitalier Universitaire de Besançon, Centre Léon Bérard, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Centre National de la Recherche Scientifique, Institut pour l'avancée des biosciences, CHU Dijon Bourgogne, Hôpital Universitaire Dupuytren, Centre Hospitalier Universitaire de Reims, Centre Hospitalier Régional Universitaire de Brest, Hôpitaux Universitaires Henri-Mondor, Centre Hospitalier Universitaire de Montpellier, Centre Hospitalier Universitaire de Nantes
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410816822