MIA calculator for predicting recurrence-free and overall survival of patients with stage II melanoma

Improvements in recurrence-free survival (RFS) were demonstrated in two recent randomized trials for patients with sentinel node (SN)-negativestage IIb or IIc melanoma receiving adjuvant pembrolizumab or nivolumab. However, adverse events also occurred. Accurate individualized prognostic estimates of RFS and overall survival (OS) would allow patients to more accurately weigh the risks and benefits of adjuvant therapy. Researchers at Melanoma Institute Australia (MIA; Sydney) developed a multivariable risk prediction calculator (MIA calculator) that provides estimates of 5- and 10-year RFS and OS for these patients (n=3,220), with independent validation in two cohorts in the USA and The Netherlands. The 5-year and 10-year RFS C-statistics were 0.70 and 0.73 for the MIA-model, versus 0.61 and 0.60 for models based on AJCC-8 staging models, respectively. For OS, the 5-year and 10-year C-statistics were 0.71 and 0.75 (MIA-model) compared with 0.62 and 0.61 for the AJCC-8 stage models. The authors conclude that the MIA models offer accurate and personalized estimates of both RFS and OS in patients with stage II melanoma even in the absence of pathological staging with SN biopsy.