Adjuvant Pembrolizumab versus IFNα2b or Ipilimumab in Resected High-Risk Melanoma

Kenneth F. Grossmann, Megan Othus, Sapna P. Patel, Ahmad A. Tarhini, Vernon K. Sondak, Michael V. Knopp, Teresa M. Petrella, Thach Giao Truong, Nikhil I. Khushalani, Justine V. Cohen, Elizabeth I. Buchbinder, Kari Kendra, Pauline Funchain, Karl D. Lewis, Robert M. Conry, Bartosz Chmielowski, Ragini R. Kudchadkar, Douglas B. Johnson, Hongli Li, James MoonZeynep Eroglu, Brian Gastman, Magdalena Kovacsovics-Bankowski, Krishna S. Gunturu, Scot W. Ebbinghaus, Sama Ahsan, Nageatte Ibrahim, Elad Sharon, Larissa A. Korde, John M. Kirkwood, Antoni Ribas

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

We conducted a randomized phase III trial to evaluate whether adjuvant pembrolizumab for one year (647 patients) improved recurrence-free survival (RFS) or overall survival (OS) in comparison with high-dose IFNα-2b for one year or ipilimumab for up to three years (654 patients), the approved standard-of-care adjuvant immunotherapies at the time of enrollment for patients with high-risk resected melanoma. At a median follow-up of 47.5 months, pembrolizumab was associated with significantly longer RFS than prior standard-of-care adjuvant immunotherapies [HR, 0.77; 99.62% confidence interval (CI), 0.59-0.99; P = 0.002]. There was no statistically significant association with OS among all patients (HR, 0.82; 96.3% CI, 0.61-1.09; P = 0.15). Proportions of treatmentrelated adverse events of grades 3 to 5 were 19.5% with pembrolizumab, 71.2% with IFNα-2b, and 49.2% with ipilimumab. Therefore, adjuvant pembrolizumab significantly improved RFS but not OS compared with the prior standard-of-care immunotherapies for patients with high-risk resected melanoma. SIGNIFICANCE: Adjuvant PD-1 blockade therapy decreases the rates of recurrence, but not survival, in patients with surgically resectable melanoma, substituting the prior standard-of-care immunotherapies for this cancer.

Original languageEnglish (US)
Pages (from-to)644-653
Number of pages10
JournalCancer discovery
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2022

ASJC Scopus subject areas

  • Oncology

MD Anderson CCSG core facilities

  • Clinical and Translational Research Center

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