Annals of surgical oncology
October 19, 2026 · via Europe PMC
Real-World Adoption of Adjuvant Immune Checkpoint Inhibition in Stage IIB/IIC Melanoma Following FDA Approval.
Jakub JW, Doonan BP, Day CN, +5 more, Dronca RS
AI summary — for doctors, generated from the abstract only
Adjuvant checkpoint inhibitor use in stage IIB/IIC melanoma rose after FDA approval but remained uncommon and below stage III uptake.
What was studied
Registry study using the National Cancer Database and Mayo Clinic registry of stage IIB/IIC melanoma, comparing 2019-2020 with 2022 and with historical stage III uptake.
Key findings
- Among 7,039 NCDB patients, adjuvant ICI use rose from 5% before approval to 32% after.
- Most eligible patients still did not receive it, and uptake was lower than seen after stage III approval.
- Multivariable models were used to identify factors linked with receipt.
Clinical relevance
Clinicians appear to be selectively adopting adjuvant ICI in stage II melanoma given uncertainty about overall survival benefit and toxicity.
Who should care
Limitations
Registry data cannot show why patients were or were not treated, and the abstract is cut off before the factors associated with receipt.
Individualize adjuvant ICI discussions in stage IIB/IIC disease, weighing recurrence risk against immune-related toxicity and the lack of mature survival data.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
BACKGROUND
Adjuvant immune checkpoint inhibition (ICI) for stage IIB/IIC melanoma was approved in December 2021 based on recurrence-free survival benefit without mature overall survival data. Given uncertainty regarding the risk-benefit balance in this population, we evaluated real-world utilization of adjuvant ICI in the first year following FDA approval and compared uptake with historical patterns observed in stage III melanoma.
METHODS
The National Cancer Database (NCDB) and Mayo Clinic Cancer Registry were queried for patients with stage IIB/IIC melanoma diagnosed in 2019-2020 (pre-approval) and 2022 (post-approval). Utilization was compared with historical patterns for stage III melanoma surrounding its December 2017 FDA approval. Multivariable logistic regression identified factors associated with receipt of adjuvant ICI.
RESULTS
Among 7039 patients with stage IIB/IIC melanoma in NCDB, adjuvant ICI use increased from 5% pre-approval to 32% post-approval (P < .0001), with higher utilization in stage IIC (40%) than IIB (27%). Younger age was the only consistent patient-level factor associated with treatment. Within our tertiary care system, 21% of eligible patients received adjuvant ICI post-approval. By comparison, stage III utilization at NCDB sites increased from 27 to 58% in the first year following its FDA approval.
CONCLUSIONS
Adjuvant ICI use for stage IIB/IIC melanoma increased following FDA approval; however, most eligible patients did not receive therapy, and overall utilization remained lower than historical patterns observed for stage III disease, suggesting selective adoption driven by risk-benefit considerations.
DOI
10.1245/s10434-026-20378-w
PMID
42897383
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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