Beyond the Five-Year Milestone: Long‑term Survivorship of Melanoma Patients Treated Off‑Trial with anti‑PD‑1

Cancer research · Melanoma · BRAF

Off‑trial anti‑PD‑1 treatment provides excellent long‑term prognosis for melanoma patients surviving ≥ 5 years, especially if no further treatment is required in the first 5 years.

Background: Little is known about the long‑term outcomes of anti‑PD‑1 treated patients with melanoma beyond 5 years, especially for patients treated off clinical trials. Methods: This retrospective cohort study includes patients with unresectable stage III/IV non‑uveal melanoma treated with anti‑PD‑1 off trial at Memorial Sloan Kettering Cancer Center between 2014‑2017 who survived at least 5 years following their first anti‑PD‑1 dose (N=139). We characterized overall survival (OS), melanoma‑specific survival (MSS) estimates, treatment‑free survival rates, and subsequent treatment courses. Results: Median follow‑up among 5‑plus year survivors (N=125) was 78.4 months (range 60.0‑96.3). OS at year 7 (2‑years post 5‑year landmark) was 90.1% (95% CI: 83.0‑94.3%). MSS at year 7 was 95.0% (95% CI: 89.1‑97.8%). In patients who completed anti‑PD‑1 based therapy and did not require subsequent treatment by 5 years (N=80), the probability of not requiring additional treatment for an additional two years was 95.7% (95% CI: 91.0‑100%). Conclusions: Patients treated with anti‑PD‑1 regimens off clinical trials who survive at least 5 years from initial anti‑PD‑1 treatment can be reassured of their excellent long‑term prognosis, particularly if they did not require additional melanoma treatment during the first 5 years.

These findings inform clinicians and patients about the long‑term outcomes of standard‑of‑care anti‑PD‑1 therapy beyond five years, providing evidence that many patients can achieve durable remission without additional treatment and guiding surveillance and decision‑making in routine clinical practice.

Evidence level: Állatkísérletes. Állatmodellben vizsgálták.

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