Adjuvant immunotherapy in the modern management of resectable melanoma: current status and outlook to 2028

IF 8.3 2区医学 Q1 ONCOLOGY ESMO Open Pub Date : 2025-03-01 Epub Date: 2025-02-15 DOI:10.1016/j.esmoop.2025.104295

M. Donia , H. Jespersen , M. Jalving , R. Lee , H. Eriksson , C. Hoeller , M. Hernberg , I. Gavrilova , L. Kandolf , G. Liszkay , H. Helgadottir , A. Zhukavets , D. Pianova , I. Marquez-Rodas , B. Neyns , H. Westgeest , I. Pourmir , P. Sobczuk , E. Ellebaek , T. Amaral

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Abstract

Background

Therapeutic advances have reshaped the treatment landscape for patients with resectable melanoma, particularly for those with stage IIB/C and stage III disease. In this article, we discuss the current status and future outlook of adjuvant immunotherapy for melanoma in Europe.

Results

Adjuvant immunotherapy offers significant benefits in terms of recurrence-free survival and distant metastasis-free survival. Uncertainties regarding overall survival (OS) benefits, however, remain. Trials such as Keynote-054, which are expected to provide crucial OS information, have delayed their final analyses until 2027. Additionally, real-world studies have raised questions about the correlation between recurrence-free survival/distant metastasis-free survival improvements observed in clinical trials and OS outcomes in routine clinical practice. These uncertainties have led to ongoing debates about the cost-effectiveness of adjuvant therapies, with disparities in reimbursement policies across Europe reflecting these concerns.

Conclusion

Looking ahead to 2028, adjuvant immunotherapy will remain a key option of comprehensive melanoma care, particularly for patients with stage IIB/C and stage III with micrometastatic disease, where neoadjuvant immunotherapy is not feasible.

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辅助免疫治疗在可切除黑色素瘤的现代管理：现状和展望到2028年

治疗的进步重塑了可切除黑色素瘤患者的治疗前景，特别是对于IIB/C期和III期疾病患者。在本文中，我们讨论了欧洲黑色素瘤辅助免疫治疗的现状和未来展望。结果辅助免疫治疗在无复发生存和无远处转移生存方面有显著的益处。然而，总体生存（OS）效益的不确定性仍然存在。Keynote-054等试验预计将提供关键的操作系统信息，但已将最终分析推迟到2027年。此外，现实世界的研究提出了关于临床试验中观察到的无复发生存/无远处转移生存改善与常规临床实践中的OS结果之间相关性的问题。这些不确定性导致了关于辅助治疗成本效益的持续争论，欧洲各地报销政策的差异反映了这些担忧。展望2028年，辅助免疫治疗仍将是黑色素瘤综合治疗的关键选择，特别是对于IIB/C期和III期微转移性疾病患者，新辅助免疫治疗是不可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ESMO Open Medicine-Oncology

CiteScore

11.70

自引率

2.70%

发文量

255

审稿时长

10 weeks

期刊介绍： ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.