{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:05:17Z","timestamp":1789049117673,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T00:00:00Z","timestamp":1670803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Programmed death\u20101 (PD\u20101) antibodies and BRAF\u2009+\u2009MEK inhibitors are widely used for adjuvant therapy of fully resected high\u2010risk melanoma. Little is known about treatment efficacy outside of phase III trials. This real\u2010world study reports on clinical outcomes of modern adjuvant melanoma treatment in specialized skin cancer centers in Germany, Austria and Switzerland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multicenter, retrospective study investigating stage III\u2013IV melanoma patients receiving adjuvant nivolumab (NIV), pembrolizumab (PEM) or dabrafenib\u2009+\u2009trametinib (D\u2009+\u2009T) between 1\/2017 and 10\/2021. The primary endpoint was 12\u2010month recurrence\u2010free survival (RFS). Further analyses included descriptive and correlative statistics, and a multivariate linear\u2010regression machine learning model to assess the risk of early melanoma recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 1198 patients from 39 skin cancer centers from Germany, Austria and Switzerland were analysed. The vast majority received anti PD\u20101 therapies (<jats:italic>n<\/jats:italic>\u00a0=\u00a01003). Twelve\u2010month RFS for anti PD\u20101 and BRAF\u2009+\u2009MEK inhibitor\u2010treated patients were 78.1% and 86.5%, respectively (hazard ratio [HR] 1.998 [95% CI 1.335\u20132.991]; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001). There was no statistically significant difference in overall survival (OS) in anti PD\u20101 (95.8%) and BRAF\u2009+\u2009MEK inhibitor (96.9%) treated patients (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05) during the median follow\u2010up of 17\u2009months. Data indicates that anti PD\u20101 treated patients who develop immune\u2010related adverse events (irAEs) have lower recurrence rates compared to patients with no irAEs (HR 0.578 [95% CI 0.443\u20130.754], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001). BRAF mutation status did not affect overall efficacy of anti PD\u20101 treatment (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). In both, anti PD\u20101 and BRAF\u2009+\u2009MEK inhibitor treated cohorts, data did not show any difference in 12\u2010month RFS and 12\u2010month OS comparing patients receiving total lymph node dissection (TLND) versus sentinel lymph node biopsy only (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). The recurrence prediction model reached high specificity but only low sensitivity with an AUC\u00a0=\u00a00.65. No new safety signals were detected. Overall, recorded numbers and severity of adverse events were lower than reported in pivotal phase III trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite recent advances in adjuvant melanoma treatment, early recurrence remains a significant clinical challenge. This study shows that TLND does not reduce the risk of early melanoma recurrence and should only be considered in selected patients. Data further highlight that variables collected during clinical routine are unlikely to allow for a clinically relevant prediction of individual recurrence risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.18779","type":"journal-article","created":{"date-parts":[[2022,11,26]],"date-time":"2022-11-26T14:26:06Z","timestamp":1669472766000},"page":"894-906","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Real\u2010world outcomes using <scp>PD<\/scp>\u20101 antibodies and <scp>BRAF<\/scp>\u00a0+\u2009<scp>MEK<\/scp> inhibitors for adjuvant melanoma treatment from 39 skin cancer centers in Germany, Austria and Switzerland"],"prefix":"10.1111","volume":"37","author":[{"given":"Katharina","family":"Schumann","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK) Technical University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Mauch","sequence":"additional","affiliation":[{"name":"Department for Dermatology and Venereology and CIO ABCD University Hospital K\u00f6ln  K\u00f6ln Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai\u2010Christian","family":"Klespe","sequence":"additional","affiliation":[{"name":"Department for Dermatology and Venereology and CIO ABCD University Hospital K\u00f6ln  K\u00f6ln Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Loquai","sequence":"additional","affiliation":[{"name":"Department for Dermatology Johannes Gutenberg\u2010University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Nikfarjam","sequence":"additional","affiliation":[{"name":"Department for Dermatology Johannes Gutenberg\u2010University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Schlaak","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Ak\u00e7etin","sequence":"additional","affiliation":[{"name":"Department for Dermatology and Allergy Ludwig\u2010Maximilian University  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"K\u00f6lblinger","sequence":"additional","affiliation":[{"name":"Department for Dermatology and Allergology Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Hoellwerth","sequence":"additional","affiliation":[{"name":"Department for Dermatology and Allergology Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Meissner","sequence":"additional","affiliation":[{"name":"Department for Dermatology University Clinic Frankfurt  Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guelcin","family":"Mengi","sequence":"additional","affiliation":[{"name":"Department for Dermatology University Clinic Frankfurt  Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas Dominik","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital Magdeburg  Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Mengoni","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital Magdeburg  Magdeburg 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