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Tumor Discovery

ORIGINAL RESEARCH ARTICLE
Adjuvant immunotherapy in high-risk resectable

melanoma: A real-world experience

Mohammad Usman Hakeem , Gabriela Marsavela 2 , Afaf Abed 3,4,5 , and
1†
Muhammad Adnan Khattak 2,4† *
1 Department of Medical Oncology, Linear Clinical Research Institute, Nedlands, Western Australia,
Australia
2 Department of Medical Oncology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
3 Department of Medical Oncology, Centre for Precision Health, Edith Cowan University, Joondalup,
Western Australia, Australia
4 Department of Medical Oncology, School of Medical and Health Sciences, Edith Cowan University,
Joondalup, Western Australia, Australia
5 Department of Medical Oncology, School of Medicine, University of Western Australia, Crawley,
Western Australia, Australia

Abstract
Adjuvant immunotherapy with nivolumab or pembrolizumab represents the current
standard of care for resected high-risk Stage III and IV malignant melanoma. However,
data on its real-world outcomes and efficacy beyond clinical trials are limited. We
evaluated the data of high-risk Stage III and IV melanoma patients treated with adjuvant
† These authors contributed equally immunotherapy in two hospitals in Western Australia, Australia. The study involved
to this work.
the retrospective collection and analysis of data from 95 eligible patients treated
*Corresponding author: with nivolumab or pembrolizumab. These patients were planned to receive 1 year of
Muhammad Adnan Khattak
(muhammad.khattak@health. immunotherapy, with treatment continuing until disease recurrence, unacceptable
wa.gov.au) toxicity, or voluntary withdrawal. Our evaluation focused on overall survival (OS),
recurrence-free survival (RFS), and distant metastasis-free survival (DMFS), along with
Citation: Hakeem MU, Marsavela
G, Abed A, Khattak MA. Adjuvant safety outcomes. The findings of our study indicated a 2-year RFS of 73%, a DMFS of
immunotherapy in high-risk 73%, and an OS of 94%. Treatment-related adverse events were observed in 63.1% of
resectable melanoma: A real- patients, with cutaneous manifestations being the most common treatment-related
world experience. Tumor Discov.
2024;3(3):3143. toxicity and gastrointestinal tract issues being the most common higher-grade
doi: 10.36922/td.3143 immune-related adverse event. Importantly, these findings do not significantly differ
Received: March 11, 2024 from the landmark clinical trials, CheckMate-238 and KEYNOTE-054. In conclusion,
adjuvant immune checkpoint inhibitor therapy administered for up to 1 year in high-
Accepted: June 19, 2024
risk Stage III and IV melanoma demonstrates a comparable efficacy and toxicity profile
Published Online: August 2, 2024 in real-world settings to that observed in the pivotal trials.
Copyright: © 2024 Author(s).
This is an Open-Access article
distributed under the terms of the Keywords: High-risk melanoma; Resectable; Real-world data; Adjuvant; Immunotherapy
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited. 1. Introduction
Publisher’s Note: AccScience Melanoma is a formidable cutaneous cancer arising from the malignant transformation
Publishing remains neutral with of melanocytes. Risk factors contributing to its development include sun exposure,
regard to jurisdictional claims in 1
published maps and institutional phenotypic traits, and genotype. In Australia, melanoma ranked as the third most
affiliations. diagnosed cancer in 2021, with an age-standardized incidence rate of 55 cases/100,000

Volume 3 Issue 3 (2024) 1 doi: 10.36922/td.3143