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European Journal of Dermatology

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Management of adjuvant settings for Stage III melanoma patients in France prior to checkpoint inhibitors: epidemiological data from the RIC-Mel database Article à paraître

Auteurs
Brigitte Dréno on behalf of the RIC-Mel Network 2 *
1 Department of Dermatology, Université de Lyon, Institut de Cancérologie des HCL, Centre de Recherche en Cancérologie de Lyon, Lyon, France
2 Department of Oncodermatology, Université de Nantes, CHU Nantes, CIC 1413, CRCINA, Nantes, France
3 Department of Epidemiology and Biostatistics, CHU Nantes, CRCINA, INSERM 1232, Université de Nantes, Nantes, France
4 Department of Dermatology, Centre d’Onco-Dermatologie, CHU-CLCC de Rennes, Rennes, France
5 Department of Dermatology, CHU de Nice, Hôpital l’Archet, Nice, France
6 Department of Dermatology, CHRU de Montpellier, Groupe Hospitalier Saint Eloi, Montpellier, France
7 Department of Dermatology, Université de Lille, Inserm U 1189, CHRU de Lille, Lille, France
8 Department of Dermatology, CHU de Grenoble, Hôpital Albert Michalon, La Tronche, France
9 Department of Dermatology, CH Valence, Valence, France
10 Department of Dermatology, Groupe Hospitalier La Rochelle-Ré-Aunis, La Rochelle, France
11 Department of Dermatology, Institut Universitaire du Cancer de Toulouse et CHU de Toulouse, Toulouse, France
12 Department of Dermatology, CHU de Bordeaux, Bordeaux, France
13 Department of Dermatology, CHU de Dijon, Dijon, France
14 Department of Dermatology, AP-HP Hôpital Saint-Louis, INSERM U976, Faculté Paris 7 Diderot, Paris, France
* Reprints
a These authors contributed equally.

Background: Targeted therapies such as BRAF and MEK inhibitors and immunotherapies have been made available to treat melanoma. Objectives: To provide an overview of the management of the French Stage III melanoma population after complete lymph node resection prior to new adjuvant therapies. Materials and Methods: A subgroup data analysis. Results: Data from 1,835 patients were analysed (15.58% Stage IIIA, 39.24% Stage IIIB, 43.92% Stage IIIC and 1.25% Stage IIID). Superficial spreading melanoma was the most frequent (70.98% in Stage IIIA for whom mutation analysis was performed; BRAF mutation was identified in up to 62% Stage IIIA patients). Sentinel lymph node biopsy was performed in 88.46% of Stage IIIA patients, 42.36% of Stage IIIB, 53.97% of Stage IIIC and 34.78% of Stage IIID. Up to 80% of Stage IIIA patients had no adjuvant treatment follow-up. Ulceration (p = 0.004; RR: 2.98; 95% CI: 1.4-6.3) and age at diagnosis (p = 0.0002; RR: 1.04; 95% CI: 1.02-1.06) were significant predictive factors for survival. Adjuvant interferon-α was administered in up to 13.04% of Stage IIID patients. Conclusion: Only a small number of Stage III melanoma patients were treated with interferon-α in adjuvant settings. New adjuvant therapies are currently having an effect on clinical practice in France, increasing survival and decreasing cost.