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Outcomes with adjuv...
Outcomes with adjuvant anti-PD-1 therapy in patients with sentinel lymph node-positive melanoma without completion lymph node dissection
- Article/chapterEnglish2022
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LIBRIS-ID:oai:gup.ub.gu.se/318577
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https://gup.ub.gu.se/publication/318577URI
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https://doi.org/10.1136/jitc-2021-004417DOI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Until recently, most patients with sentinel lymph node-positive (SLN+) melanoma underwent a completion lymph node dissection (CLND), as mandated in published trials of adjuvant systemic therapies. Following multicenter selective lymphadenectomy trial-II, most patients with SLN+ melanoma no longer undergo a CLND prior to adjuvant systemic therapy. A retrospective analysis of clinical outcomes in SLN+ melanoma patients treated with adjuvant systemic therapy after July 2017 was performed in 21 international cancer centers. Of 462 patients who received systemic adjuvant therapy, 326 patients received adjuvant anti-PD-1 without prior immediate (IM) CLND, while 60 underwent IM CLND. With median follow-up of 21 months, 24-month relapse-free survival (RFS) was 67% (95% CI 62% to 73%) in the 326 patients. When the patient subgroups who would have been eligible for the two adjuvant anti-PD-1 clinical trials mandating IM CLND were analyzed separately, 24-month RFS rates were 64%, very similar to the RFS rates from those studies. Of these no-CLND patients, those with SLN tumor deposit >1 mm, stage IIIC/D and ulcerated primary had worse RFS. Of the patients who relapsed on adjuvant anti-PD-1, those without IM CLND had a higher rate of relapse in the regional nodal basin than those with IM CLND (46% vs 11%). Therefore, 55% of patients who relapsed without prior CLND underwent surgery including therapeutic lymph node dissection (TLND), with 30% relapsing a second time; there was no difference in subsequent relapse between patients who received observation vs secondary adjuvant therapy. Despite the increased frequency of nodal relapses, adjuvant anti-PD-1 therapy may be as effective in SLN+ pts who forego IM CLND and salvage surgery with TLND at relapse may be a viable option for these patients.
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Broman, K. K.
(author)
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Thompson, J. F.
(author)
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Nijhuis, A.
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Hieken, T. J.
(author)
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Kottschade, L.
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Farma, J. M.
(author)
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Hotz, M.
(author)
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Deneve, J.
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Fleming, M.
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Bartlett, E. K.
(author)
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Sharma, A.
(author)
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Dossett, L.
(author)
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Hughes, T.
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Gyorki, D. E.
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Downs, J.
(author)
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Karakousis, G.
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Song, Y.
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Lee, A.
(author)
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Berman, R. S.
(author)
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van Akkooi, A.
(author)
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Stahlie, E.
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Han, D. L.
(author)
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Vetto, J.
(author)
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Beasley, G.
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Farrow, N. E.
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Hui, J. Y. C.
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Moncrieff, M.
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Nobes, J.
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Baecher, K.
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Perez, M.
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Lowe, M.
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Ollila, D. W.
(author)
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Collichio, F. A.
(author)
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Olofsson Bagge, Roger,1978Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Sahlgrenska Centrum för Cancerforskning (SCCR),Institute of Clinical Sciences, Department of Surgery,Sahlgrenska Center for Cancer Research (SCCR)(Swepub:gu)xoloro
(author)
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Mattsson, JanGothenburg University,Göteborgs universitet,Sahlgrenska Centrum för Cancerforskning (SCCR),Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Sahlgrenska Center for Cancer Research (SCCR),Institute of Clinical Sciences, Department of Surgery
(author)
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Kroon, H. M.
(author)
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Chai, H.
(author)
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Teras, J.
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Sun, J.
(author)
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Carr, M. J.
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Tandon, A.
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Babacan, N. A.
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Kim, Y.
(author)
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Naqvi, M.
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Zager, J.
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Khushalani, N. I.
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Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för kirurgi
(creator_code:org_t)
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In:Journal for Immunotherapy of Cancer: BMJ10:82051-1426
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Eroglu, Z.
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Broman, K. K.
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Thompson, J. F.
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Nijhuis, A.
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Hieken, T. J.
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Kottschade, L.
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show more...
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Farma, J. M.
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Hotz, M.
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Deneve, J.
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Fleming, M.
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Bartlett, E. K.
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Sharma, A.
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Dossett, L.
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Hughes, T.
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Gyorki, D. E.
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Downs, J.
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Karakousis, G.
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Song, Y.
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Lee, A.
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Berman, R. S.
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van Akkooi, A.
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Stahlie, E.
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Han, D. L.
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Vetto, J.
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Beasley, G.
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Farrow, N. E.
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Hui, J. Y. C.
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Moncrieff, M.
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Nobes, J.
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Baecher, K.
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Perez, M.
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Lowe, M.
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Ollila, D. W.
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Collichio, F. A.
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Olofsson Bagge, ...
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Mattsson, Jan
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Kroon, H. M.
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Chai, H.
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Teras, J.
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Sun, J.
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Carr, M. J.
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Tandon, A.
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Babacan, N. A.
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Kim, Y.
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Naqvi, M.
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Zager, J.
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Khushalani, N. I ...
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