For patients with high-risk resected melanoma, adjuvant pembrolizumab improves quality of life (QOL) compared with standard of care with ipilimumab or high-dose interferon α 2b (HDI), according to a study published online Nov. 23 in JAMA Oncology.

Joseph M. Unger, Ph.D., from the Fred Hutchinson Cancer Center in Seattle, and colleagues compared QOL in patients with resected melanoma at high risk for relapse who were treated with adjuvant pembrolizumab or standard of care. A total of 832 patients from the S1404 phase 3 randomized clinical trial were included and were evaluable for the primary QOL end point at cycle 3.

The researchers found that the adjusted Functional Assessment of Cancer Therapy (FACT) Biological Response Modifiers (FACT-BRM) trial outcome index (TOI) score at cycle 3 was 9.6 points higher for pembrolizumab versus ipilimumab/HDI, which exceeded the prespecified clinically meaningful difference. Differences by arm exceeded 5 points in favor of pembrolizumab in linear-mixed models through cycle 7. FACT-BRM TOI scores favored the pembrolizumab arm compared with the subset of patients receiving ipilimumab or HDI (differences, 6.0 and 17.0 points, respectively) in post-hoc analyses.

"Physicians should be encouraged to incorporate and discuss treatment-related QOL issues with patients when making shared decisions regarding the risks and benefits of adjuvant therapy in resected melanoma," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Merck, which manufactures pembrolizumab and partially funded the study.

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