Adjuvant treatment of in-transit melanoma: Narrowing the knowledge gap left by clinical trials

Melissa M de Meza*, Willeke A M Blokx, Han J Bonenkamp, Cristian U Blank, Maureen J B Aarts, Franchette W P J van den Berkmortel, Marye J Boers-Sonderen, Jan Willem B de Groot, John B Haanen, Geke A P Hospers, Ellen W Kapiteijn, Olivier J van Not, Djura Piersma, Rozemarijn S van Rijn, Marion A Stevense-Den Boer, Astrid A M van der Veldt, Gerard Vreugdenhil, Alfons J M van den Eertwegh, Karijn P M Suijkerbuijk, Michel W J M Wouters

*Corresponding author for this work

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Abstract

Few clinical trials address efficacy of adjuvant systemic treatment in patients with in-transit melanoma (ITM). This study describes adjuvant systemic therapy of ITM patients beyond clinical trials. In this study, we included stage III adjuvant-treated melanoma patients registered in the nationwide Dutch Melanoma Treatment Registry between July 2018 and December 2020. Patients were divided into three groups: nodal disease only, ITM only and ITM and nodal disease. Recurrence patterns, recurrence-free survival (RFS) and overall survival (OS) at 12-months were analyzed. In our study population of 1037 patients, 66.8% had nodal disease only, 16.7% had ITM only and 16.2% had ITM with nodal disease. RFS at 12-months was comparable in the nodal only and ITM only group (72.2% vs70.1%, P = .97) but lower in ITM and nodal disease patients (57.8%; P = .01, P < .01). Locoregional metastases occurred as first recurrence in 38.9% nodal disease only, 71.9% of ITM-only and 44.0% of ITM and nodal disease patients. Distant recurrences occurred in 42.3%, 18.8% and 36.0%, respectively (P = .02). 12-months OS was not significantly different for nodal disease only patients compared with ITM-only (94.4% vs 97.6%, P = .06) but was significantly higher for ITM-only compared with ITM and nodal disease patients (97.6% vs 91.0%, P < .01). In conclusion, we showed that in the adjuvant setting, RFS rates in ITM-only patients are similar to non-ITM, though better than in ITM and nodal disease patients. Adjuvant-treated ITM-only patients less often experience distant recurrences and have a superior OS compared with ITM and nodal disease patients.

Original languageEnglish
Pages (from-to)389-398
Number of pages10
JournalInternational Journal of Cancer
Volume153
Issue number2
Early online date26 Feb 2023
DOIs
Publication statusPublished - 15 Jul 2023

Bibliographical note

Publisher Copyright:
© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

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