Multicenter retrospective study of real-world outcomes of adjuvant anti-PD-1 therapy after resection of melanoma

Adjuvant anti-PD-1 based immunotherapy had improved outcomes after resection of stage IIB to IV melanoma in clinical trials; however, little is know about real-world outcomes of this therapy. A retrospective study at 8 centers in Spain found that in clinical practice outcomes with adjuvant anti-PD-1 therapy were worse than what was seen in clinical trials. Prognostic factors associated with recurrence were melanoma primary site and starting adjuvant therapy more than 12 weeks after the last resection (HR 1.68; 95% CI 1.13-2.50). Development of grade 3 or 4 immune-related adverse events was associated with better recurrence-free survival (HR 0.40; 95% CI 0.19-0.87). Early relapse, during adjuvant therapy or within 12 weeks after completion of adjuvant therapy accounted for 63% of total recurrences. The authors conclude that in clinical practice outcomes with adjuvant anti-PD-1 based therapy, survival outcomes were worse than those reported in clinical trials.