{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T15:36:19Z","timestamp":1783697779579,"version":"3.55.0"},"reference-count":23,"publisher":"Yeungnam University College of Medicine","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["HR22C1832"],"award-info":[{"award-number":["HR22C1832"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-jyms.org"],"crossmark-restriction":true},"short-container-title":["JYMS"],"abstract":"<jats:p>Background: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced malignant melanoma. This study examined the real-world efficacy of dacarbazine (dimethyl triazeno imidazole carboxamide, DTIC) in patients who had previously received pembrolizumab, based on the hypothesis that prior ICI treatment enhances the therapeutic response to subsequent chemotherapy.Methods: This retrospective study included 71 patients with histologically confirmed malignant melanoma treated at Kyungpook National University Chilgok Hospital (Daegu, Korea) between 2011 and 2023. The patients received DTIC for unresectable stage IIIC, IIID, or IV melanoma (American Joint Committee on Cancer, 8th edition).Results: Among the 71 patients, the median patient age was 64 years (range, 25\u201389 years). When categorized by melanoma subtype, 18 patients (25.4%) had acral melanoma, 40 (56.3%) had cutaneous melanoma, and 13 (18.3%) had mucosal melanoma. Sixteen of the DTIC-treated patients had not received pembrolizumab previously (DTI-only group), while 55 had (pem-DTIC group). The median progression-free survival was 2.3 months in the DTIC-only group and 3.9 months in the pem-DTIC group (hazard ratio [HR], 0.246; 95% confidence interval [CI], 0.106\u20130.576; &lt;i&gt;p&lt;\/i&gt;=0.001). The median overall survival was 6.8 months in the DTIC-only group and 19.0 months in the pem-DTIC group (HR, 0.198; 95% CI, 0.068\u20130.574; &lt;i&gt;p&lt;\/i&gt;=0.003). The duration of response (DoR) was 4.64 months in the DTIC group and 8.11 months in the pem-DTIC group.Conclusion: This study demonstrated that the DoR to DTIC was prolonged following ICI therapy (4.64 months vs. 8.11 months). This indicates that prior ICI treatment may enhance tumor sensitivity to chemotherapy, making DTIC a viable option for treating refractory, relapsed, or progressive melanoma.<\/jats:p>","DOI":"10.12701\/jyms.2026.43.14","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T01:15:31Z","timestamp":1768785331000},"page":"14","update-policy":"https:\/\/doi.org\/10.12701\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Extended therapeutic efficacy of dacarbazine following prior treatment with immune checkpoint inhibitors in metastatic melanoma: a single center retrospective study in Korea"],"prefix":"10.12701","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4523-2330","authenticated-orcid":true,"given":"Jihyun","family":"Na","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2999-1018","authenticated-orcid":true,"given":"Jun 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