Prognostic factors and outcomes of adjuvant and first-line metastatic treatments in melanoma a Turkish oncology group study
Abstract Management of melanoma has changed significantly with the discovery of targeted therapies and immune checkpoint inhibitors (ICI). Our aim in the study is to determine which treatment alternatives, specifically dabrafenib plus trametinib and ICIs, are effective in adjuvant therapy and which...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-025-87553-z |
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| author | Nargiz Majidova Hacı Arak Faruk Recep Ozalp Onur Bas Gulhan Ozcelik Koker Erkan Buket Ozmarasalı Yasemin Sagdıc Karateke Teoman Sakalar Sendag Yaslikaya Ilknur Deliktas Onur Goncagul Akdag Ali Ogul Murad Guliyev Elif Sahin Ebru Engin Delipoyraz Ali Alkan Okan Aydın Nurullah Ilhan Ozkan Alan Sinem Akbas Yaprak Cağlar Ali Kaan Guren Nadiye Sever Halil Ibrahim Ellez Fatih Selcukbiricik Mustafa Muhammed Atcı Ahmet Bilici Nebi Serkan Demirci Tugba Basoglu Cengiz Karacin Ismail Oguz Kara Bulent Yıldız Turkkan Evrensel Mustafa Karaca Omer Dizdar Elif Atag Alpaslan Ozgun Osman Kostek |
| author_facet | Nargiz Majidova Hacı Arak Faruk Recep Ozalp Onur Bas Gulhan Ozcelik Koker Erkan Buket Ozmarasalı Yasemin Sagdıc Karateke Teoman Sakalar Sendag Yaslikaya Ilknur Deliktas Onur Goncagul Akdag Ali Ogul Murad Guliyev Elif Sahin Ebru Engin Delipoyraz Ali Alkan Okan Aydın Nurullah Ilhan Ozkan Alan Sinem Akbas Yaprak Cağlar Ali Kaan Guren Nadiye Sever Halil Ibrahim Ellez Fatih Selcukbiricik Mustafa Muhammed Atcı Ahmet Bilici Nebi Serkan Demirci Tugba Basoglu Cengiz Karacin Ismail Oguz Kara Bulent Yıldız Turkkan Evrensel Mustafa Karaca Omer Dizdar Elif Atag Alpaslan Ozgun Osman Kostek |
| author_sort | Nargiz Majidova |
| collection | DOAJ |
| description | Abstract Management of melanoma has changed significantly with the discovery of targeted therapies and immune checkpoint inhibitors (ICI). Our aim in the study is to determine which treatment alternatives, specifically dabrafenib plus trametinib and ICIs, are effective in adjuvant therapy and which treatment is effective as first-line metastatic therapy. This retrospective, multicenter study included 120 patients diagnosed with stage IIIB-IIID melanoma receiving both adjuvant and first-line metastatic treatment between 2007 and 2023. Data on clinicopathologic characteristics, treatment regimens and outcomes were collected. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) were analyzed. Patients treated with dabrafenib plus trametinib as adjuvant therapy had the longest relapse-free survival (RFS) (median: 8.3 months), followed by those treated with interferon (4.1 months) and nivolumab (1.9 months) (p = 0.002). Metastatically, the highest ORR was observed in patients treated with dabrafenib plus trametinib (54.5%), followed by ICI (52.0%) and chemotherapy (33.3%). Similarly, DCR was superior for dabrafenib plus trametinib (86.3%) compared to ICI (70.8%) and chemotherapy (66.6%). Median PFS was 9.7 months (95% CI 7.2–12.2 months) in the whole group. This was 14.3 months (95% CI 9.6–19.0 months) with ICI, 10.3 months (95% CI 4.2–16.4 months) with BRAF/MEK inhibitors and 6.3 months (95% CI 4.7–7.9 months) with chemotherapy, which was statistically significant (p < 0.001). Dabrafenib plus trametinib showed the longest median OS (53.5 months) in metastatic patients and was significantly better than chemotherapy (33.6 months) (p < 0.001). BRAF V600E mutation, RFS > 6 months, ORR are all independent factors for OS prognosis. In our study, dabrafenib plus trametinib combination was more effective in adjuvant treatment of melanoma, while immunotherapy was more effective in metastatic first-line treatment. |
| format | Article |
| id | doaj-art-9828f0522bfd4c938176e3ac69348cb2 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-9828f0522bfd4c938176e3ac69348cb22025-01-26T12:31:47ZengNature PortfolioScientific Reports2045-23222025-01-011511810.1038/s41598-025-87553-zPrognostic factors and outcomes of adjuvant and first-line metastatic treatments in melanoma a Turkish oncology group studyNargiz Majidova0Hacı Arak1Faruk Recep Ozalp2Onur Bas3Gulhan Ozcelik Koker4Erkan Buket Ozmarasalı5Yasemin Sagdıc Karateke6Teoman Sakalar7Sendag Yaslikaya8Ilknur Deliktas Onur9Goncagul Akdag10Ali Ogul11Murad Guliyev12Elif Sahin13Ebru Engin Delipoyraz14Ali Alkan15Okan Aydın16Nurullah Ilhan17Ozkan Alan18Sinem Akbas19Yaprak Cağlar20Ali Kaan Guren21Nadiye Sever22Halil Ibrahim Ellez23Fatih Selcukbiricik24Mustafa Muhammed Atcı25Ahmet Bilici26Nebi Serkan Demirci27Tugba Basoglu28Cengiz Karacin29Ismail Oguz Kara30Bulent Yıldız31Turkkan Evrensel32Mustafa Karaca33Omer Dizdar34Elif Atag35Alpaslan Ozgun36Osman Kostek37Division of Medical Oncology, VM Medical Park Maltepe HospitalDivision of Medical Oncology, Gaziantep City HospitalDivision of Medical Oncology, Dokuz Eylül University Faculty of MedicineDivision of Medical Oncology, Hacettepe University Cancer InstituteDivision of Medical Oncology, Akdeniz University Faculty of MedicineDivision of Medical Oncology, Uludag University Faculty of MedicineDivision of Medical Oncology, Osmangazi University HospitalDivision of Medical Oncology, Kahramanmaras Necip Fazıl City HospitalsDivision of Medical Oncology, Cukurova University School of MedicineDivision of Medical Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research HospitalDivision of Medical Oncology, Kartal Dr. Lütf Kirdar City Hospital, Health Science UniversityDivision of Medical Oncology, University of Health Sciences-Adana Health Practice and Research CenterDivision of Medical Oncology, Cerrahpaşa Faculty of Medicine, İstanbul University- CerrahpaşaDivision of Medical Oncology, Kocaeli City HospitalDivision of Medical Oncology, Medipol University HospitalDivision of Medical Oncology, Muğla Sıtkı Koçman University Training and Research HospitalDivision o f Medical Oncology, Sağlık Bilimleri UniversityDivision o f Medical Oncology, İstanbul Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research HospitalDivision of Medical Oncology, Koç University HospitalDivision of Medical Oncology, Koç University HospitalDivision of Medical Oncology, Marmara University School of MedicineDivision of Medical Oncology, Marmara University School of MedicineDivision of Medical Oncology, Marmara University School of MedicineDivision of Medical Oncology, Şanlıurfa Mehmet Akif İnan Education and Research HospitalDivision of Medical Oncology, Koç University HospitalDivision o f Medical Oncology, Sağlık Bilimleri UniversityDivision of Medical Oncology, Medipol University HospitalDivision of Medical Oncology, Cerrahpaşa Faculty of Medicine, İstanbul University- CerrahpaşaDivision of Medical Oncology, Kartal Dr. Lütf Kirdar City Hospital, Health Science UniversityDivision of Medical Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research HospitalDivision of Medical Oncology, Cukurova University School of MedicineDivision of Medical Oncology, Osmangazi University HospitalDivision of Medical Oncology, Uludag University Faculty of MedicineDivision of Medical Oncology, Akdeniz University Faculty of MedicineDivision of Medical Oncology, Hacettepe University Cancer InstituteDivision of Medical Oncology, Dokuz Eylül University Faculty of MedicineDivision of Medical Oncology, Faculty of Medicine, University of Health Sciences Sultan Abdulhamid Han Training and Research HospitalDivision of Medical Oncology, Marmara University School of MedicineAbstract Management of melanoma has changed significantly with the discovery of targeted therapies and immune checkpoint inhibitors (ICI). Our aim in the study is to determine which treatment alternatives, specifically dabrafenib plus trametinib and ICIs, are effective in adjuvant therapy and which treatment is effective as first-line metastatic therapy. This retrospective, multicenter study included 120 patients diagnosed with stage IIIB-IIID melanoma receiving both adjuvant and first-line metastatic treatment between 2007 and 2023. Data on clinicopathologic characteristics, treatment regimens and outcomes were collected. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) were analyzed. Patients treated with dabrafenib plus trametinib as adjuvant therapy had the longest relapse-free survival (RFS) (median: 8.3 months), followed by those treated with interferon (4.1 months) and nivolumab (1.9 months) (p = 0.002). Metastatically, the highest ORR was observed in patients treated with dabrafenib plus trametinib (54.5%), followed by ICI (52.0%) and chemotherapy (33.3%). Similarly, DCR was superior for dabrafenib plus trametinib (86.3%) compared to ICI (70.8%) and chemotherapy (66.6%). Median PFS was 9.7 months (95% CI 7.2–12.2 months) in the whole group. This was 14.3 months (95% CI 9.6–19.0 months) with ICI, 10.3 months (95% CI 4.2–16.4 months) with BRAF/MEK inhibitors and 6.3 months (95% CI 4.7–7.9 months) with chemotherapy, which was statistically significant (p < 0.001). Dabrafenib plus trametinib showed the longest median OS (53.5 months) in metastatic patients and was significantly better than chemotherapy (33.6 months) (p < 0.001). BRAF V600E mutation, RFS > 6 months, ORR are all independent factors for OS prognosis. In our study, dabrafenib plus trametinib combination was more effective in adjuvant treatment of melanoma, while immunotherapy was more effective in metastatic first-line treatment.https://doi.org/10.1038/s41598-025-87553-zAdjuvant therapyDabrafenib plus trametinibChemotherapyImmune checkpoint inhibitorsMelanomaSurvival outcomes |
| spellingShingle | Nargiz Majidova Hacı Arak Faruk Recep Ozalp Onur Bas Gulhan Ozcelik Koker Erkan Buket Ozmarasalı Yasemin Sagdıc Karateke Teoman Sakalar Sendag Yaslikaya Ilknur Deliktas Onur Goncagul Akdag Ali Ogul Murad Guliyev Elif Sahin Ebru Engin Delipoyraz Ali Alkan Okan Aydın Nurullah Ilhan Ozkan Alan Sinem Akbas Yaprak Cağlar Ali Kaan Guren Nadiye Sever Halil Ibrahim Ellez Fatih Selcukbiricik Mustafa Muhammed Atcı Ahmet Bilici Nebi Serkan Demirci Tugba Basoglu Cengiz Karacin Ismail Oguz Kara Bulent Yıldız Turkkan Evrensel Mustafa Karaca Omer Dizdar Elif Atag Alpaslan Ozgun Osman Kostek Prognostic factors and outcomes of adjuvant and first-line metastatic treatments in melanoma a Turkish oncology group study Scientific Reports Adjuvant therapy Dabrafenib plus trametinib Chemotherapy Immune checkpoint inhibitors Melanoma Survival outcomes |
| title | Prognostic factors and outcomes of adjuvant and first-line metastatic treatments in melanoma a Turkish oncology group study |
| title_full | Prognostic factors and outcomes of adjuvant and first-line metastatic treatments in melanoma a Turkish oncology group study |
| title_fullStr | Prognostic factors and outcomes of adjuvant and first-line metastatic treatments in melanoma a Turkish oncology group study |
| title_full_unstemmed | Prognostic factors and outcomes of adjuvant and first-line metastatic treatments in melanoma a Turkish oncology group study |
| title_short | Prognostic factors and outcomes of adjuvant and first-line metastatic treatments in melanoma a Turkish oncology group study |
| title_sort | prognostic factors and outcomes of adjuvant and first line metastatic treatments in melanoma a turkish oncology group study |
| topic | Adjuvant therapy Dabrafenib plus trametinib Chemotherapy Immune checkpoint inhibitors Melanoma Survival outcomes |
| url | https://doi.org/10.1038/s41598-025-87553-z |
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