Prognostic factors and outcomes of adjuvant and first-line metastatic treatments in melanoma a Turkish oncology group study

• Published in: Scientific reports 2025-01, Vol.15 (1), p.3200-8, Article 3200
• Main Authors: Majidova, Nargiz, Arak, Hacı, Ozalp, Faruk Recep, Bas, Onur, Koker, Gulhan Ozcelik, Ozmarasalı, Erkan Buket, Karateke, Yasemin Sagdıc, Sakalar, Teoman, Yaslikaya, Sendag, Onur, Ilknur Deliktas, Akdag, Goncagul, Ogul, Ali, Guliyev, Murad, Sahin, Elif, Delipoyraz, Ebru Engin, Alkan, Ali, Aydın, Okan, Ilhan, Nurullah, Alan, Ozkan, Akbas, Sinem, Cağlar, Yaprak, Guren, Ali Kaan, Sever, Nadiye, Ellez, Halil Ibrahim, Selcukbiricik, Fatih, Muhammed Atcı, Mustafa, Bilici, Ahmet, Demirci, Nebi Serkan, Basoglu, Tugba, Karacin, Cengiz, Kara, Ismail Oguz, Yıldız, Bulent, Evrensel, Turkkan, Karaca, Mustafa, Dizdar, Omer, Atag, Elif, Ozgun, Alpaslan, Kostek, Osman
• Format: Article
• Language: English
• Subjects: 631/154; 631/67; Adjuvant therapy; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cell survival; Chemotherapy; Chemotherapy, Adjuvant - methods; Dabrafenib plus trametinib; Disease control; Female; Humanities and Social Sciences; Humans; Imidazoles - administration & dosage; Imidazoles - therapeutic use; Immune checkpoint inhibitors; Immune Checkpoint Inhibitors - therapeutic use; Immunotherapy; Male; Medical prognosis; MEK inhibitors; Melanoma; Melanoma - drug therapy; Melanoma - mortality; Melanoma - pathology; Metastases; Metastasis; Middle Aged; multidisciplinary; Neoplasm Metastasis; Neoplasm Staging; Nivolumab - administration & dosage; Nivolumab - therapeutic use; Oximes - administration & dosage; Oximes - therapeutic use; Prognosis; Pyridones - administration & dosage; Pyridones - therapeutic use; Pyrimidinones - administration & dosage; Pyrimidinones - therapeutic use; Retrospective Studies; Science; Science (multidisciplinary); Statistical analysis; Survival outcomes; Treatment Outcome; Turkey - epidemiology
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-025-87553-z

Management of melanoma has changed significantly with the discovery of targeted therapies and immune checkpoint inhibitors (ICI). Our aim in the study is to determine which treatment alternatives, specifically dabrafenib plus trametinib and ICIs, are effective in adjuvant therapy and which treatment is effective as first-line metastatic therapy. This retrospective, multicenter study included 120 patients diagnosed with stage IIIB-IIID melanoma receiving both adjuvant and first-line metastatic treatment between 2007 and 2023. Data on clinicopathologic characteristics, treatment regimens and outcomes were collected. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) were analyzed. Patients treated with dabrafenib plus trametinib as adjuvant therapy had the longest relapse-free survival (RFS) (median: 8.3 months), followed by those treated with interferon (4.1 months) and nivolumab (1.9 months) ( p  = 0.002). Metastatically, the highest ORR was observed in patients treated with dabrafenib plus trametinib (54.5%), followed by ICI (52.0%) and chemotherapy (33.3%). Similarly, DCR was superior for dabrafenib plus trametinib (86.3%) compared to ICI (70.8%) and chemotherapy (66.6%). Median PFS was 9.7 months (95% CI 7.2–12.2 months) in the whole group. This was 14.3 months (95% CI 9.6–19.0 months) with ICI, 10.3 months (95% CI 4.2–16.4 months) with BRAF/MEK inhibitors and 6.3 months (95% CI 4.7–7.9 months) with chemotherapy, which was statistically significant ( p