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Time to recurrence of metastatic melanoma not associated with survival rates

In patients with metastatic melanoma, the timing of advanced disease was not associated with the timing of first distant recurrence, according to a multicentric cohort study.

Study subjects were enrolled in the French MelBase database from March 1, 2013, to Sept. 1, 2017, and were treated with first-line immunotherapies, targeted therapies or chemotherapy or were in open clinical trials with at least 3 months of follow-up.

Data for 638 adults with unresectable stage III or IV melanoma were analyzed, including timing of primary excision, first distant recurrence, treatment commencement, disease progression and death; 274 patients were treated with first-line immunotherapies, 180 were treated with targeted therapies, 132 were in open clinical trials and 52 received chemotherapy.

The median time period from primary excision to first distant recurrence was 25 months, ranging from 12 to 55 months, the study said. The median time from primary excision to treatment initiation was 27 months, ranging from 14 to 57 months.

The researchers found no evidence of an association between time to first distant recurrence (TFDR) and progression-free survival when TFDR was considered as a continuous variable (HR = 0.99; 95% CI, 0.99-1.01). Similarly, they found no association with progression-free survival when TFDR was considered as a categorical variable from 12 months to 24 months (HR = 0.75; 95% CI, 0.56-1.02) or at greater than 24 months, (HR = 0.62; 95% CI, 0.47-1.01).

There was also no association between TFDR and overall survival.

“Our findings confirm more recent data concerning the unpredictability of cancer relapse. ... Permissive metastatic niches seem to play an important role in [the switch from dormant cells to an active metastatic process], but it is unclear to what extent and under what circumstances this supportive microenvironment underlies micrometastatic dormancy,” Anaïs Vallet, MD, from the department of dermatology, Hôpital Saint-Louis, Paris, and colleagues wrote. – by Abigail Sutton

Disclosures: Vallet reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.