Sex-specific survival in advanced metastatic melanoma – a DeCOG study on 2032 patients of the multicenter prospective skin cancer registry ADOREG

Leven AS, Peters T, Rajcsanyi LS, Weichenthal M, Mohr P, Meier F, von Wasielewski I, Gutzmer R, Utikal J, Terheyden P, Herbst R, Haferkamp S, Pföhler C, Leiter U, Forschner A, Kreuter A, Gebhardt C, Lutze S, Weishaupt C, Grabbe S, Debus D, Hassel J, Welzel J, Heinzerling L, Berking C, Loquai C, Gambichler T, Ziemer M, Becker JC, Tasdogan A, Zimmer L, Livingstone E, Schadendorf D, Roesch A, Hinney A, Ugurel S (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Book Volume: 227

Article Number: 115668

DOI: 10.1016/j.ejca.2025.115668

Abstract

Background: Females and males differ in their innate and acquired immune responses. Thus, it is hypothesized that the efficacy of anti-tumor immunotherapies may differ by sex. This study aimed to investigate sex-specific survival differences upon different therapy types in metastatic melanoma. Patients and Methods: Patients with unresectable metastatic melanoma (stage IV, AJCCv8) of the skin or unknown primary, who had received first-line PD-1-based immune checkpoint inhibition (ICI) or BRAF/MEK-directed targeted therapy (TT) were identified from the prospective multicenter DeCOG skin cancer registry ADOREG. Study endpoints were progression-free survival (PFS) and overall survival (OS). Results: A total of 2032 patients, 1274 males (62.7 %) and 758 females (37.3 %), received ICI (n = 1484) or TT (n = 548) between May 2010 and December 2020. At median follow-up of 28.6 months, no significant sex-specific differences in survival could be detected, neither in the total cohort nor by treatment type: PFS (total, p = 0.86; ICI, p = 0.46; TT, p = 0.21), OS (total, p = 0.60; ICI, p = 0.20; TT, p = 0.30). Multivariable Cox regression analyses also did not show a relevant prognostic influence by sex. Subgroup analyses were performed according to ICI therapy type. In n = 872 patients treated with PD-1 monotherapy, a survival advantage (PFS, p = 0.041; OS, p = 0.07) could be detected for males by univariable and multivariable analyses, whereas no sex-specific survival differences were found for n = 456 patients who received combination immunotherapy. Conclusion: No overall sex-specific survival differences were detected for metastatic melanoma patients in the first-line therapy setting. According to subgroup analyses males show a trend towards a survival advantage over females.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Essen Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Elbe Kliniken Stade-Buxtehude Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Johannes Wesling Klinikum Minden Germany (DE) Universitätsklinikum Mannheim Germany (DE) Universität zu Lübeck Germany (DE) HELIOS Kliniken Germany (DE) Universitätsklinikum Regensburg Germany (DE) Universitätsklinikum des Saarlandes (UKS) Germany (DE) Eberhard Karls Universität Tübingen Germany (DE) Universität Witten/Herdecke Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsmedizin Greifswald / Universitätsklinikum Greifswald Germany (DE) Universitätsklinikum Münster Germany (DE) Universitätsmedizin der Johannes Gutenberg-Universität Mainz Germany (DE) Paracelsus Medizinische Privatuniversität, Nürnberg Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Universität Augsburg Germany (DE) Klinikum der Universität München Germany (DE) Klinikum Bremen-Ost Germany (DE) Universitätsklinikum Leipzig Germany (DE) Universität Bielefeld Germany (DE)

How to cite

APA:

Leven, A.S., Peters, T., Rajcsanyi, L.S., Weichenthal, M., Mohr, P., Meier, F.,... Ugurel, S. (2025). Sex-specific survival in advanced metastatic melanoma – a DeCOG study on 2032 patients of the multicenter prospective skin cancer registry ADOREG. European Journal of Cancer, 227. https://doi.org/10.1016/j.ejca.2025.115668

MLA:

Leven, Anna Sophia, et al. "Sex-specific survival in advanced metastatic melanoma – a DeCOG study on 2032 patients of the multicenter prospective skin cancer registry ADOREG." European Journal of Cancer 227 (2025).

BibTeX: Download