Advanced stage melanoma during pregnancy: recommendations from a retrospective, multicentre, registry-based study

Year: 2025

Type: article

Abstract: Background Diagnosis and treatment of advanced melanoma during pregnancy represents a major challenge, with scarce data on outcome or management available. Therefore, the Melanoma Pregnancy Taskforce collected real-world data to understand the current management approaches. Methods This retrospective, multicenter database included patients who were either diagnosed with advanced melanoma (newly diagnosed or recurrent) during pregnancy (group 1) or conceived while on systemic treatment (group 2) between 01/01/2011 and 07/31/2024. Information regarding patient, primary tumor and advanced melanoma characteristics, intervention or treatment during pregnancy, and outcomes of mother and fetus were collected using a standardized, de-identified form. Findings 72 women from seven countries were identified. In group 1 (n = 63), nine pregnancies were terminated, and two miscarried. Median gestational age of live births was 34 weeks (IQR 32–37). Nine patients initiated systemic treatment during pregnancy; 56 (85%) of 66 switched or initiated new treatment after delivery. 5-year overall survival was 53% (95% CI 39–71), with median follow-up of 27 months (IQR 1.0–4.8 years). In group 2 (n = 10), four pregnancies were terminated, one miscarried. Of the six live births, median gestational age was 33 weeks (IQR 32–NR). Seven (63%) of nine initiated new or continued treatment after delivery. 5-year overall survival was 71% (95% CI 51–100), with median follow-up of 42 months (IQR 2.5–4.5 years). One neonate born at 26 weeks died after three days and one had a fatal congenital malformation. One child with third trimester vemurafenib-exposure had cardiac malformations, and two neonates experienced toxicity after in utero immunotherapy exposure. No children developed melanoma, despite five placentas with melanoma involvement. Interpretation Here, we present the data from the largest contemporary dataset of outcomes of women diagnosed with advanced stage melanoma during pregnancy and provide recommendations for the diagnosis and management of advanced melanoma during pregnancy. Funding Not applicable.

Source: EClinicalMedicine

DOI: 10.1016/j.eclinm.2025.103501

Institutions: The Netherlands Cancer Institute, Vanderbilt University Medical Center, Essen University Hospital, Deutsches Konsortium für Translationale Krebsforschung, Dana-Farber Cancer Institute, Mayo Clinic, Mayo Clinic in Florida, The University of Texas MD Anderson Cancer Center, University of Colorado Anschutz, Angeles Clinic and Research Institute, Duke University, University Hospital Zurich, The University of Sydney, Melanoma Institute Australia, Royal North Shore Hospital, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", University of Pittsburgh, University of Pittsburgh Medical Center, University Medical Center Groningen, University of Groningen, Northwestern University, Northwestern Memorial Hospital, The University of Queensland, Princess Alexandra Hospital, Assistance Publique – Hôpitaux de Paris, Hôpital Saint-Louis, Sarah Cannon, Tennessee Oncology, University of Tübingen, University of Utah, Huntsman Cancer Institute, Universitair Ziekenhuis Leuven, University of California, San Francisco, UCSF Helen Diller Family Comprehensive Cancer Center, Moffitt Cancer Center, Leiden University Medical Center, Centre Hospitalier Universitaire Vaudois

Language: English

Topic: Cutaneous Melanoma Detection and Management

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $5,780

OpenAlex ID: W4415507172