Refining adjuvant therapy options in patients with stage II melanoma.

IF 2.3 4区医学 Q3 IMMUNOLOGY

Immunotherapy Pub Date : 2026-05-01 Epub Date: 2026-06-12 DOI:10.1080/1750743X.2026.2688694

Bryant Morocho, Sasha Lightfoot, Ponnandai Somasundar, Steve Kwon

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引用次数: 0

Abstract

Aims: Patients with stage II melanoma have multiple adjuvant therapy options in national guidelines. We evaluated management strategies to better define treatment in this heterogeneous population.

Methods: Using the National Cancer Database (2010-2021), we identified patients with pathological stage IIA-IIC cutaneous melanoma who underwent surgical resection. Adjuvant treatment categories included no additional therapy (i.e. surgery only), immunotherapy, radiation, and immunotherapy plus radiation. Multivariable Cox proportional models evaluated overall survival by T-stage groups: T2b/T3a, T3b/T4a, and T4b and margin status (negative vs. positive).

Results: 54,848 patients were identified (T2b/T3a n = 26,916; T3b/T4a n = 18,547; T4b n = 9,385). With negative margins, adjuvant therapy did not improve survival in T2b/T3a patients. Adjuvant immunotherapy in the negative margin cohort improved survival in T3b/T4a (HR 0.52, 95% CI: 0.44-0.62) and T4b (HR 0.54, 95% CI: 0.47-0.62) melanoma. Among patients with positive margins, no benefit was observed with adjuvant therapy of any modality among all T-stage group cohorts.

Conclusion: The impact of adjuvant treatment on overall survival in stage II melanoma depended on T-stage and margin status. Patients with low-risk disease had no survival benefit, while those with high-risk melanoma, T3b/T4a and T4b, benefited from adjuvant immunotherapy after R0 resection.

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改进II期黑色素瘤患者的辅助治疗方案。

目的：在国家指南中，II期黑色素瘤患者有多种辅助治疗选择。我们评估了管理策略，以便更好地确定这一异质人群的治疗方法。方法：使用国家癌症数据库（2010-2021），我们确定了病理分期为IIA-IIC期的皮肤黑色素瘤患者，并进行了手术切除。辅助治疗类别包括无附加治疗（即仅手术）、免疫治疗、放射治疗和免疫治疗加放射治疗。多变量Cox比例模型通过t分期组（T2b/T3a、T3b/T4a和T4b）和切缘状态（阴性与阳性）评估总生存率。结果：共纳入54,848例患者（T2b/T3a n = 26,916; T3b/T4a n = 18,547; T4b n = 9,385）。当切缘为阴性时，辅助治疗不能提高T2b/T3a患者的生存率。阴性切缘队列的辅助免疫治疗改善了T3b/T4a （HR 0.52, 95% CI: 0.44-0.62）和T4b （HR 0.54, 95% CI: 0.47-0.62）黑色素瘤的生存率。在切缘阳性的患者中，在所有t期组队列中，没有观察到任何形式的辅助治疗的益处。结论：辅助治疗对II期黑色素瘤总生存期的影响取决于t分期和边缘状态。低风险疾病患者没有生存获益，而高风险黑色素瘤（T3b/T4a和T4b）患者在R0切除后受益于辅助免疫治疗。

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

Immunotherapy 医学-免疫学

CiteScore

5.00

自引率

3.60%

发文量

113

审稿时长

6-12 weeks

期刊介绍： Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field. Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.