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Adjuvant immunotherapy in the modern management of resectable melanoma: current status and outlook to 2028

Donia, M.
; 
Jespersen, H.
; 
Jalving, M.
; 
Lee, R.
; 
Eriksson, H.
; 
Hoeller, C.
; 
Hernberg, M.
; 
Gavrilova, I.
; 
Kandolf, L.
; 
Liszkay, G.
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Abstract
BACKGROUND: Therapeutic advances have reshaped the treatment landscape for patients with resectable melanoma, particularly for those with stage IIB/C and stage III disease. In this article, we discuss the current status and future outlook of adjuvant immunotherapy for melanoma in Europe. RESULTS: Adjuvant immunotherapy offers significant benefits in terms of recurrence-free survival and distant metastasis-free survival. Uncertainties regarding overall survival (OS) benefits, however, remain. Trials such as Keynote-054, which are expected to provide crucial OS information, have delayed their final analyses until 2027. Additionally, real-world studies have raised questions about the correlation between recurrence-free survival/distant metastasis-free survival improvements observed in clinical trials and OS outcomes in routine clinical practice. These uncertainties have led to ongoing debates about the cost-effectiveness of adjuvant therapies, with disparities in reimbursement policies across Europe reflecting these concerns. CONCLUSION: Looking ahead to 2028, adjuvant immunotherapy will remain a key option of comprehensive melanoma care, particularly for patients with stage IIB/C and stage III with micrometastatic disease, where neoadjuvant immunotherapy is not feasible.
Authors
Donia, M.
Jespersen, H.
Jalving, M.
Lee, R.
Eriksson, H.
Hoeller, C.
Hernberg, M.
Gavrilova, I.
Kandolf, L.
Liszkay, G.
Helgadottir, H.
Zhukavets, A.
Pianova, D.
Marquez-Rodas, I.
Neyns, B.
Westgeest, H.
Pourmir, I.
Sobczuk, P.
Ellebaek, E.
Amaral, T.
Affiliation
National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Denmark. Electronic address: marco.donia@regionh.dk. Department of Oncology, Oslo University Hospital, Oslo, Norway. University Medical Centre Groningen, Groningen, The Netherlands. Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK; Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK. Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Theme Cancer Skin Cancer Center, Karolinska University Hospital, Stockholm, Sweden. Department of Dermatology, Medical University of Vienna, Vienna, Austria. Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland; Helsinki University, Helsinki, Finland. University Hospital for Active Treatment of Oncology, Sofia, Bulgaria. Faculty of Medicine, Military Medical Academy, Belgrade, Serbia. National Institute of Oncology, Budapest, Hungary; Middle-Eastern European Academy, Budapest, Hungary. Department of Oncology, Belarusian State Medical University, Minsk, Belarus. Riga Stradins University, Riga, Latvia. Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain. Universitair Ziekenhuis Brussel (UZ Brussel), Department of Medical Oncology, Brussels, Belgium. Amphia Hospital, Department of Internal Medicine, Breda, The Netherlands. European Georges Pompidou Hospital, Department of Thoracic Oncology, Paris, France; INSERM U970, Immunotherapy and Antiangiogenic Treatment in Oncology, Paris, France. Maria Slodowska-Curie National Research Institute of Oncology in Warsaw, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw, Poland. National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Denmark. Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany; Cluster of Excellence iFIT (EXC 2180) 'Image-Guided and Functionally Instructed Tumor Therapies', Tübingen, Germany. Electronic address: Teresa.Amaral@med.uni-tuebingen.de.
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2025
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All Christie Publications
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Article
Citation
Donia M, Jespersen H, Jalving M, Lee R, Eriksson H, Hoeller C, et al. Adjuvant immunotherapy in the modern management of resectable melanoma: current status and outlook to 2028. ESMO open. 2025 Mar;10(3):104295. PubMed PMID: 39954389. Pubmed Central PMCID: PMC11872484. Epub 2025/02/16. eng.
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https://christie.openrepository.com/handle/10541/627484
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