1175P - Return to work after neoadjuvant versus adjuvant immunotherapy in stage III melanoma patients

Background

Neoadjuvant immunotherapy in stage III melanoma improved event-free survival compared to 1 year adjuvant therapy. Six weeks of neoadjuvant combination immunotherapy, currently tested in phase III, induces even higher response rates, allowing frequently the omission of extensive surgery and adjuvant therapy. These developments and the rising incidence of melanoma will lead to an exponential increase of melanoma long-term survivors. However, immunotherapy can cause somatic and psychological adverse effects impairing patients’ daily life including their return to work (RTW), which has also a strong societal impact. Therefore, we analyzed RTW after neoadjuvant versus adjuvant immunotherapy.

Methods

88 patients (44 neoadjuvant, 44 adjuvant), 18-66 years old, working (including voluntary work) at start therapy were included to be retrospectively telephone-interviewed concerning their RTW. Partial RTW was defined as RTW after initial discontinuation of work; full RTW was the timepoint that patients worked the same capacity, hours as prior to therapy. Database lock was date January, 3rd 2023.

Results

Patient characteristics were balanced, except for extent of surgery (index or sentinel lymph node procedure only vs therapeutic lymph node dissection) which was more frequently less extensive in the neoadjuvant cohort (64% vs 36%). Patients returned to work more quickly in the neoadjuvant group compared to the adjuvant cohort, with a 6-month partial RTW cumulative incidence of 80% vs 58% and 84% versus 73% at 12 months. At 24 months the adjuvant group catched up and partial RTW was almost the same with 91% and 92%. Incidence of full RTW was higher at all timepoints for the neoadjuvant cohort compared to the adjuvant cohort with 55% vs 38%, 70% vs 50% and 82% vs 62% at 6, 12 and 24 months, respectively. Aside neoadjuvant therapy, lower level of education, and larger extent of surgery were independent parameters associated with reduced RTW.

Conclusions

Our study suggests that treatment duration, the extent of surgery, and educational level might be factors influencing return to work in patients with stage III melanoma.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

C.U. Blank: Financial Interests, Institutional, Advisory Board: BMS, MSD, Roche, Novartis, GSK, AZ, Pfizer, Lilly, GenMab, Pierre Fabre; Financial Interests, Personal, Advisory Board: Third Rock Ventures; Financial Interests, Personal, Stocks/Shares: Immagene; Financial Interests, Institutional, Coordinating PI: NanoString, BMS, Novartis, 4SC; Financial Interests, Personal, Stocks/Shares, intention to develop IFN signature algorithm: NewCo, no name yet; Other, pending patent: WO 2021/177822 A1. All other authors have declared no conflicts of interest.