Abstract 1175P
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.
Resources from the same session
1100P - Open-label non-randomized phase IB study to characterize the safety, tolerability and recommended dose of tinostamustin in combination with nivolumab in patients with advanced melanoma (ENIGMA)
Presenter: Markus Joerger
Session: Poster session 13
1101P - The effect of LNS8801 in combination with pembrolizumab in patients with treatment-refractory cutaneous melanoma
Presenter: Jordi Rodon
Session: Poster session 13
1102P - Evaluation of surrogate endpoints for overall survival within the RELATIVITY-047 trial
Presenter: Peter Mohr
Session: Poster session 13
1103P - Nivolumab (NIVO) plus relatlimab (RELA) vs NIVO in previously untreated metastatic or unresectable melanoma: 2-year subgroup analyses from RELATIVITY-047
Presenter: Georgina Long
Session: Poster session 13
1104P - Efficacy of immune checkpoint inhibition in metastatic or non-resectable melanoma after failure of adjuvant anti-PD1 treatment: A EUMelareg real-world evidence study
Presenter: Michael Weichenthal
Session: Poster session 13
1105P - First-line nivolumab plus ipilimumab in advanced melanoma patients previously treated with adjuvant systemic therapy
Presenter: Katarzyna Kozak
Session: Poster session 13
1106P - Anti-PD-1 (PD1) monotherapy or in combination with anti-CTLA-4 for metastatic melanoma (MM) patients (pts) with liver metastases (mets)
Presenter: Ines Pires da Silva
Session: Poster session 13
1107P - BRAF mutation status does not impact outcomes with tebentafusp in advanced cutaneous melanoma
Presenter: Alexander Shoushtari
Session: Poster session 13
1108P - Outcomes of patients with unresectable or metastatic melanoma after cessation of immunotherapy following complete response or toxicities
Presenter: Nur Sakinah Zulkifli
Session: Poster session 13