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
1119P - Stage IIIA melanoma with isolated tumor cells in lymph nodes: Time for reviewing the AJCC v8 classification
Presenter: Teresa Amaral
Session: Poster session 13
1120P - Development and external validation of a clinical prediction model to predict recurrence-free survival and melanoma-specific survival in patients with melanoma after sentinel lymph node biopsy
Presenter: Robert Stassen
Session: Poster session 13
1121P - Interferon-gamma (IFNy) gene signature as a predictive biomarker for response in lactate dehydrogenase (LDH) low advanced melanoma patients
Presenter: Lotte Hoeijmakers
Session: Poster session 13
1122P - Neutrophil/lymphocyte ratio and systemic inflammatory index as prognostic biomarkers in metastatic melanoma patients under immune checkpoint inhibitors: Could any of them be used?
Presenter: Maria Menezes
Session: Poster session 13
1123P - Baseline tumor-infiltrating lymphocytes and response to immune checkpoint inhibition in advanced melanoma
Presenter: Mark Schuiveling
Session: Poster session 13
1124P - IL-6 as prognostic factor in adjuvant or metastatic skin cancer patients treated with immunotherapy: A deep biomarker analysis
Presenter: Domenico Mallardo
Session: Poster session 13
1125P - Identification of a subset of metastatic melanoma patients demonstrating germline determined insensitivity to immunotherapy
Presenter: Benjamin Fairfax
Session: Poster session 13
1126P - REtrospective Study of definitive therapy for head and neck mUcosal MElanoma: The RESUME study
Presenter: Motoo Nomura
Session: Poster session 13
1127P - Efficacy of immune checkpoint inhibitors (ICIs) in advanced mucosal melanoma (MM): A systematic review and meta-analysis
Presenter: James Pham
Session: Poster session 13
1128P - A phase I dose escalation and expansion study of FHD-286, a novel BRG1/BRM (SMARCA4/SMARCA2) inhibitor, for the treatment of metastatic uveal melanoma
Presenter: Sapna Patel
Session: Poster session 13