Perioperative PD‐1‐inhibition in melanoma patients – a retrospective analysis from eight German skin cancer centers
Nina Flatt, Corinna Kochanek, Yenny Angela, Jessica C Hassel, Andrea Forschner, Christoffer Gebhardt, Miriam Mengoni, Kai‐Martin Thoms, Markus Heppt, Julian Kött, Carsten Schulz, Lukas Flatz, Thomas Tüting, Mareike Alter, Katrin Schaper‐Gerhardt, Ralf GutzmerSummary
Background : Adjuvant therapy with anti‐PD‐1 monotherapy in melanoma is well established. However, a perioperative approach starting immunotherapy before surgery appears mechanistically more reasonable and emerging research results suggest a clinical benefit. This study aims to provide a comprehensive overview of the current use of perioperative anti‐PD‐1 monotherapy in Germany.
Patients and methods : Patients with stage III melanoma who received perioperative anti‐PD‐1 monotherapy from April 2019 to March 2025 were included. Data from eight German skin cancer centers were retrospective collected including histological and radiological assessments.
Results : We identified 75 melanoma patients with perioperative anti‐PD‐1 monotherapy. Surgery was conducted in 75% of patients after a median of 11 weeks after therapy initiation. Pathological assessment revealed a major pathological response (MPR) in 46.5% of cases, a partial pathological response in 23.2%, and no pathological response in 30.4%. A moderate to strong correlation between radiological and pathological responses was identified. During a median follow up period of 11.6 months, melanoma recurrence was observed in 16 patients (21%). The longest recurrence‐free survival was seen in the MPR group.
Conclusions : Perioperative anti‐PD‐1 monotherapy has been implemented in routine clinical practice in German skin cancer centers. The observed outcomes are comparable to data reported from prospective studies.