Koett, Julian and Zell, Tim and Zimmermann, Noah and Ruenger, Alessandra and Smit, Daniel J. and Abeck, Finn and Geidel, Glenn and Hansen-Abeck, Inga and Heidrich, Isabel and Weichenthal, Michael and Ugurel, Selma and Leiter, Ulrike and Berking, Carola and Gutzmer, Ralf and Schadendorf, Dirk and Zimmer, Lisa and Livingstone, Elisabeth and von Wasielewskii, Imke and Mohrj, Peter and Meier, Friedegund and Haferkamp, Sebastian and Drexler, Konstantin and Herbst, Rudolf and Kellner, Ivonne and Utikal, Jochen and Wohlfeil, Sebastian A. and Pfoehler, Claudia and Adam, Leonie and Terheyden, Patrick and Ulrich, Jens and Meiss, Frank and Moebes, Monica and Welzel, Julia and Schillingu, Bastian and Ziller, Fabian and Kaatz, Martin and Kreuter, Alexander and Sindrilaru, Anca and Dippel, Edgar and Sachse, Michael and Weishaupt, Carsten and Huening, Svea and Heinzerling, Lucie and Loequai, Carmen and Schley, Gaston and Gambichler, Thilo and Loffler, Harald and Grabbe, Stephan and Schultz, Erwin and Devereux, Nina and Hassel, Jesscia C. and Simon, Jan-Ch. and Raap, Ulrike and Assaf, Chalid and Klemke, Claus-Detlev and Sunderkoetter, Cord and Hofmann, Silke C. and Wenk, Saskia and Tronnier, Michael and Thies, Silke and Heppt, Markus V. and Eggermont, Alexander and Schulze, Hans-Joachim and Zouboulis, Christos C. and Tuting, Thomas and Bauer, Alexander T. and Schneider, Stefan W. and Gebhardt, Christoffer (2025) Improved survival of advanced melanoma patients receiving immunotherapy with concomitant antithrombotic therapy - A multicenter study on 2419 patients from the prospective skin cancer registry ADOReg. EUROPEAN JOURNAL OF CANCER, 214: 115159. ISSN 0959-8049, 1879-0852
Full text not available from this repository. (Request a copy)Abstract
Background: Cancer immunotherapy has revolutionized melanoma treatment, but the high number of non- responders still emphasizes the need for improvement of therapy. One potential avenue for enhancing antitumor treatment is through the modulation of coagulation and platelet activity. Both have been found to play an important role in the tumor microenvironment, tumor growth and metastasis. Preclinical studies indicate a beneficial effect, clinical data has been inconsistent. Methods: We examined a cohort of advanced, non-resectable melanoma patients (n = 2419) derived from the German prospective multicenter skin cancer registry ADOReg, who were treated with immune checkpoint inhibitors (ICI). The patients were classified based on whether it was documented that they received platelet aggregation inhibition (PAI) (n = 137) (acetylsalicylic acid (ASA) or clopidogrel), anticoagulation (AC) (n = 185) (direct oral anticoagulation (DOAC), phenprocoumon, heparins) at the start of ICI or no antithrombotic medication (n = 2097) at any point during ICI treatment. The study endpoints were best overall response (BOR), progression-free survival (PFS) and overall survival (OS). Results: A significantly improved PFS was observed in patients documented to receive ASA (15.1 vs 6.4 months, HR 0.67, 95 % CI: 0.5 to 0.88, p = 0.0047) as well as in patients to receive AC (15.1 vs. 6.4 months, HR 0.7, 95 % CI: 0.53 to 0.91, p = 0.01) compared to patients for whom no antithrombotic medication was documented. Multivariate analysis of OS showed significant risk reduction in patients who received DOAC (HR 0.68, 95 % CI: 0.49 to 0.92, p = 0.0170) or phenprocoumon (HR: 0.44, 95 % CI: 0.19 to 0.85, p = 0.0301). Conclusion: Our study indicates a positive prognostic effect of anticoagulant and antiplatelet concomitant medication in melanoma patients receiving ICI. Further studies are needed to confrim the cancer-related benefit of adding anticoagulation or platelet inhibition to ICI treatment.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | IMMUNE CHECKPOINT INHIBITORS; VON-WILLEBRAND-FACTOR; MALIGNANT-MELANOMA; RISK; PROGNOSIS; Melanoma; Immunotherapy; Immune checkpoint inhibition (ICI); Anticoagulation; Immunothrombosis; Platelets |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Dermatologie und Venerologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Apr 2026 12:16 |
| Last Modified: | 07 Apr 2026 12:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65742 |
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