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Melanoma

Sunday Poster Presentation 2

P20: Patterns of Recurrence after Adjuvant Treatment in Melanoma and Factors Predicting Recurrence

Sunday, February 18, 2024
2:40 PM - 2:45 PM AST
Location: Miramar I & II
Disclosure(s):
Derek Effiom, MBBS: No financial relationships to disclose
Introduction: Despite effective adjuvant systemic therapies for high-risk melanoma many patients still recur. Our previous work showed improved recurrence free survival when comparing PD-1 or BRAF-MEK adjuvant therapies to surgery alone. However, factors correlated to recurrence have not yet been investigated. Our study looks to evaluate histopathological and genomic data in adjuvant treated melanoma patients to identify factors predictive for recurrence.   


Methods: We began by performing a single-center retrospective study on a subgroup of the overall cohort. Patients with stage IIB or greater, treated with either PD-1 or BRAF-MEK therapy were included. Demographic, clinical and tumor data were collected. Genomic data was derived using internal NGS platform (SNaPshot) on fixed tumor samples.  


Results: To date 18 patients have been carefully analyzed. Of these 10 were treated with PD-1 (mean age: 54.4) and 8 with BRAF-MEK targeted therapy (mean age: 59.8).  The median time to recurrence was 59.1 weeks (28.2 -78.4) and 52.8 weeks (40.9 – 81.3) in the PD-1 and BRAF-MEK group respectively; the median survival time was 47 months (38.5 -72.3) and 59.5 months (51.5 – 66.5) respectively. Prior to recurrence 87.5% of patients treated with BRAF-MEK experienced an adverse event compared to 60% in the PD-1 group. Within the PD-1 group, 40% of patients used systemic steroids prior to recurrence, higher than 25% in the BRAF-MEK group. 24 distinct genetic mutations were identified in at least one tumor analyzed. 20% of the PD1-treated patients carried a BRAF mutation. The PD1-treated cohort were more likely to experience a distant recurrence, with 60% of those who recurred presenting with a lung metastasis.  


Conclusions: Our preliminary work in a subgroup of patients provides descriptive clinical and mutational information in relation to melanoma recurrence. On-going work will complete this analysis for the extended cohort to allow statistical analysis investigating which variables will predict recurrence.

Learning Objectives:

  • Upon completion, attain a greater insight into the factors associated with recurrence in patients treated with adjuvant therapy for melanoma.
  • Understand the role of genomic data in relation to recurrence following adjuvant treatment.
  • Differentiate the clinical outcomes in patients treated with BRAF-MEK targeted therapy vs anti-PD-1 immune checkpoint therapy.