{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:38:53Z","timestamp":1785465533196,"version":"3.56.0"},"reference-count":57,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82272857"],"award-info":[{"award-number":["82272857"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Melanoma frequently harbors BRAF, NRAS, or KIT mutations which influence both tumor development and treatment strategies. For example, it is still controversial whether adjuvant anti\u2010PD\u20101 monotherapy or BRAF\/MEK inhibitors may better improve the survival for resected BRAF\u2010mutant melanoma. Furthermore, outcomes for melanoma with NRAS and KIT mutation receiving adjuvant immunotherapy remain unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred seventy\u2010four stage III melanoma patients who underwent radical surgery in Fudan University Shanghai Cancer Center (FUSCC) during January 2017 to December 2021 were included in this real\u2010world study. Patients were followed up until death or May 30th, 2022. Pearson's chi\u2010squared test or Fisher's exact test was performed for univariable analysis of the different category groups. Log\u2010rank analysis was used to identify the prognostic factors for disease\u2010free survival (DFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 41 (23.6%) patients with BRAF mutation, 31 (17.8%) with NRAS mutation, 17 (9.8%) with KIT mutation, and 85 (48.9%) wild\u2010type patients without either genomic alteration of those three genes. Most ( <jats:italic>n<\/jats:italic> \u2009=\u2009118, 67.8%) of them were acral melanoma, while 45 (25.9%) were cutaneous subtype, and 11 were (6.3%) primary unknown. Among them, 115 (66.1%) patients received pembrolizumab or toripalimab monotherapy as adjuvant therapy; 22 (12.6%) patients received high\u2010dose interferon (IFN), and 37 (21.3%) patients were just for observation. There was no statistical difference in clinicopathologic factors between anti\u2010PD\u20101 group and IFN\/OBS group. Of all the enrolled patients, anti\u2010PD\u20101 group had a better DFS than IFN\/OBS group ( <jats:italic>p<\/jats:italic> \u2009=\u20090.039). In anti\u2010PD\u20101 group, patients with BRAF or NRAS mutations had poorer DFS than wild\u2010type group. No survival difference was found among patients harboring different gene mutations in IFN\/OBS group. In wild\u2010type patients, anti\u2010PD\u20101 group had a better DFS than IFN\/OBS group ( <jats:italic>p<\/jats:italic> \u2009=\u20090.003), while no survival benefits were found for patients with BRAF, NRAS, or KIT mutations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although anti\u2010PD\u20101 adjuvant therapy provides a better DFS in the general population and in wild\u2010type patients, patients with BRAF, KIT or, especially, NRAS mutation may not benefit further from immunotherapy than conventional IFN treatment or observation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6234","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T09:04:04Z","timestamp":1688547844000},"page":"15945-15954","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A real\u2010world study of adjuvant <scp>anti\u2010PD<\/scp> \u20101 immunotherapy on stage <scp>III<\/scp> melanoma with <scp>BRAF<\/scp>, <scp>NRAS<\/scp>, and <scp>KIT<\/scp> mutations"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2151-6420","authenticated-orcid":false,"given":"Wei","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Musculoskeletal Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"WangJun","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ChunMeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tu","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ZhiGuo","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of gastrointestinal medical oncology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College Fudan University  Shanghai 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