Long-Term Real-World Outcomes of Adjuvant Anti-PD-1 Checkpoint Inhibition Versus Targeted Therapy in Stage III Melanoma: A Comprehensive Review

Highlights

• In real-world settings, adjuvant targeted therapy with BRAF plus MEK inhibitors shows superior recurrence-free survival (RFS) compared to PD-1 checkpoint inhibition for BRAF-mutant stage III melanoma patients.
• Rapid recurrences are notably higher in PD-1-treated patients with macroscopic lymph node metastases, pointing to distinct risk profiles.
• Shorter treatment duration (<6 months) does not compromise RFS for anti-PD-1 therapy but may adversely affect outcomes in targeted therapy.
• Integration of biomarker and microbiome research is refining neoadjuvant and adjuvant therapeutic strategies, with pathologic response emerging as a key predictor of durable remission.

Background