%0 Journal Article
%A Weichenthal, Michael
%A Ellebaek, Eva
%A Mangana, Joanna
%A Asher, Nethanel
%A Gavrilova, Iva
%A Kandolf, Lidija
%A Ugurel, Selma
%A Hausschild, Axel
%A Meier, Friedegund
%A Leiter, Ulrike
%A Livingstone, Elisabeth
%A Gebhardt, Christoffer
%A Gutzmer, Ralf
%A Ruhlmann, Christina H
%A Mahncke-Guldbrandt, Louise
%A Haslund, Charlotte A
%A Kopec, Sylwia
%A Teterycz, Paweł
%A Bender, Marc
%A Poudroux, Wilfried
%A Muñoz-Couselo, Eva
%A Berciano-Guerrero, Miguel-Angel
%A Shalamanova, Gergana
%A DePalo, Danielle K
%A Brozic, Jasmina Maric
%A Chiarion-Sileni, Vanna
%A Arance, Anna
%A Ziogas, Dimitrios
%A Robert, Caroline
%A van-de-Velde, Anthonie Obik
%A Gassama, Awa Aminata
%A Shapira, Ronnie
%A BenBetzalel, Guy
%A Grynberg, Shirly
%A Ramelyte, Egle
%A Bertoldo, Fabio
%A DelPrete, Valerio
%A Gaudy-Marqueste, Caroline
%A Mohr, Peter
%A Dummer, Reinhard
%A Ascierto, Paolo A
%A Gogas, Helen
%A Espinosa, Enrique
%A Lebbe, Celeste
%A Rutkowski, Piotr
%A Haanen, John
%A Schadendorf, Dirk
%A Svane, Inge Marie
%T Immune checkpoint inhibition in metastatic or non-resectable melanoma after failure of adjuvant anti-PD-1 treatment. A EUMelaReg real-world evidence study.
%D 2025
%@ 0959-8049
%U https://hdl.handle.net/10668/28501
%X Background: Adjuvant immune checkpoint inhibition (ICI) with anti-PD-1 antibodies in high-risk resected melanoma has been shown to improve recurrence-free survival. It is unclear whether prior adjuvant anti-PD-1 therapy is associated with altered response to subsequent ICI treatment in the metastatic setting. Methods: Using data from the European Melanoma Registry (EUMelaReg), we analyzed the efficiency of first-line (1L) ICI in non-resectable or metastatic melanoma after failure from prior adjuvant anti-PD-1 treatment. Both single-agent anti-PD-1 and combined anti-PD-1/CTLA-4 (Ipi/Nivo) 1L regimes were included in the analysis. We identified 389 patients receiving 1L ICI with prior adjuvant anti-PD-1 treatment. The control population was selected from a pool of 3390 PD-1-naive cases by 1:1 matching for the type of 1L ICI and various prognostic factors. As outcome measure, overall remission rates (ORR) were calculated and progression-free survival (PFS) was evaluated by Kaplan-Meier and Cox regression analysis. Results: Out of 389 patients, 303 (77.9 %) received Ipi/Nivo and 86 (22.1 %) anti-PD-1 in 1L. ORR was significantly lower in pre-treated patients (31.4 %) as compared to anti-PD-1 naive patients (48.8 %; p < 0.0001). Kaplan-Meier analysis showed significantly shorter median PFS for pre-treated patients. This applied to both anti-PD-1 and Ipi/Nivo treatment. Patients with early recurrence from adjuvant treatment (during or up to 12 weeks after end of treatment) showed lower ORR (28.5 %) and shorter PFS (3.1 months) than those who recurred later (37.7 % and 6.1 months, respectively). Conclusions: Patients with metastatic melanoma, previously exposed to anti-PD-1 ICI in the adjuvant setting showed significantly lower ORR and shorter PFS to 1L ICI with either Ipi/Nivo or single-agent anti-PD-1 retreatment.
%K Adjuvant treatment
%K Immunotherapy
%K Melanoma
%K Resistance
%~