{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T15:00:52Z","timestamp":1772204452466,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>A significant proportion of patients with locoregional (stage III) cutaneous melanoma recur despite adjuvant systemic therapy. Staging criteria and surgical nodal management have changed since the trials were completed. Data assessing the effect of systemic therapy compared to surveillance are limited, and factors associated with recurrence are unclear. We assessed the efficacy of adjuvant systemic therapy in real\u2010world patients and assessed whether baseline genomic characteristics could prognosticate or predict benefit from therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected demographic, histopathologic, clinical, and genomic data for patients diagnosed with stage III cutaneous melanoma. Outcomes of interest were recurrence\u2010free survival (RFS) and distant\u2010metastasis\u2010free survival (DMFS). Survival analysis was performed using the Kaplan\u2013Meier method with log\u2010rank analysis. Univariate and multivariate analyses were performed using a Cox regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and fifteen patients were included, of which 65 and 76 were treated with BRAF\/MEK inhibitors (BRAFi\/MEKi) and anti\u2010PD1 adjuvant systemic therapy respectively. Seventy four underwent active surveillance. Both adjuvant therapies reduced the hazard of recurrence when compared to patients undergoing active surveillance: anti\u2010PD1 HR: 0.32 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and BRAFi\/MEKi HR: 0.39 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Anti\u2010PD1\u2010treated patients with a BRAF V600 mutation had a shorter RFS than patients with BRAF WT melanoma (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01); this was validated in external data where the presence of a BRAF V600 mutation was associated with an increased hazard recurrence (HR: 2.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adjuvant systemic therapy improved RFS in our cohort. We found that BRAF V600 mutation was associated with a worse RFS for adjuvant anti\u2010PD1 monotherapy. The effect of BRAF mutation on the response to anti\u2010PD1 therefore may be considered when choosing between adjuvant anti\u2010PD1 and BRAFi\/MEKi for patients with BRAF V600 mutant melanoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71410","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T10:46:57Z","timestamp":1764845217000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real\u2010World Outcomes of Adjuvant Therapy in Stage III Melanoma and the Impact of Somatic Mutations"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7534-9029","authenticated-orcid":false,"given":"Derek","family":"Effiom","sequence":"first","affiliation":[{"name":"Division of Gastrointestinal and Oncologic Surgery, Department of Surgery Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston 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General Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatyana","family":"Sharova","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal and Oncologic Surgery, Department of Surgery Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Johnson","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia The University of Sydney  North Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Menzies","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia The University of Sydney  North Sydney New South Wales Australia"},{"name":"Faculty of Medicine &amp; Health The University of Sydney, Charles Perkins Center, Royal North Shore &amp; Mater Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgina","family":"Long","sequence":"additional","affiliation":[{"name":"Melanoma Institute Australia The University of Sydney  North Sydney New South Wales Australia"},{"name":"Faculty of Medicine &amp; Health The University of Sydney, Charles Perkins Center, Royal North Shore &amp; Mater Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seungyeon","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee 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