Do Low-Grade Toxicities Affect Melanoma Treatment Success?
Source: Medscape, April 2025
TOPLINE:
Among patients with stage III melanoma who received adjuvant pembrolizumab, more than 50% experienced low-grade toxicities. The results of such toxicities included patients discontinuing treatment, being hospitalized, and needing immunosuppression.
METHODOLOGY:
- Immunotherapy reduces the risk for recurrence of melanoma, but it is associated with immune-related adverse events (irAEs), including both high-grade and low-grade toxicities, which can significantly affect patients’ quality of life.
- Researchers conducted a retrospective analysis to assess the effect of low-grade toxicities among 142 patients with stage III melanoma (median age at diagnosis, 65 years) who received adjuvant pembrolizumab between December 2019 and December 2022.
- They analyzed data on toxicity, treatment discontinuation, hospital admission, disease progression, and other aspects.
Overall, 47% completed a 1-year course of adjuvant pembrolizumab. The median follow-up duration was 28 months, and the median recurrence-free survival duration was 36.2 months.
TAKEAWAY:
- Among 142 patients, 70% experienced irAEs, of whom 51% experienced only low-grade toxicities (grades 1-2) and the remaining experienced high-grade toxicities (grades 3-4).
- Among patients with only low-grade toxicities, 31% discontinued treatment and 33% needed immunosuppressive treatment.
- The rate of early treatment discontinuation was significantly higher in patients aged 65 years or older than in patients younger than 65 years (66% vs 38%, P < .001). Among patients with only low-grade toxicities who discontinued treatment because of irAEs, 73% were aged 65 years or older.
- Patients with only low-grade toxicities were significantly less likely to be hospitalized than those with high-grade toxicities (15% vs 61%, P < .001).