Successfull poster presentation at SMR in Amsterdam
The dedicated efforts of our study centres enabled us to present our project on ‘Decision Making on Adjuvant Anti-PD-1 in Stage IIB/IIC Melanoma in Europe - Interim Analysis of DECIDE-II’ at the SMR Congress 2025 in Amsterdam.
250 patients with stage IIB (60.4%) and IIC (39.6%) were included in this interim analysis. The overall treatment rate was 57.8%: of the 230 patients (92%) offered adjuvant anti-PD1 therapy, over half accepted, with higher proportion in stage IIB (54.3%) compared to stage IIC (51.5%). Treated patients were younger (median age: 64 years vs. 78 years), had a higher percentage of ECOG PS of 0 (86.5% vs. 68.0%) and exhibited fewer comorbidities (CCI: 2.3 vs. 3.7). Patients in stage IIB were slightly younger (median age: 72 years vs. 73 years), had higher proportion of ECOG PS 0 (79.5% vs 70.7%) compared to those with stage IIC.
Median EQ-5D VAS scores were significantly decreasing over the three cohorts (A > B > C) and were higher (more favorable) in stage IIB patients (78.0 vs 70.0) compared to those with stage IIC. The SDM-Q-9 scores were similar between cohort A and B (86.8 vs 81.8), indicating no meaningful difference in perceived shared decision-making.
The most important reasons for refusing therapy by cohort B were concerns about ‘possible side effects’ and the ‘age’ of the patients. Patients in cohort C (n=20, 8.0%) had a median age of 84 years, an ECOG PS >1 in 55.0% of cases, and a median EQ-5D VAS score of 65.5. Advanced age, concerns about side effects and comorbidities of the patients were key factors cited by physicians for not recommending adjuvant anti-PD1 treatment to cohort C.
In summary, the DECIDE-II interim analysis provides preliminary results, showing that adjuvant anti-PD1 treatment acceptance in stage IIB/C tends to be lower due to patient’s higher age and comorbidity rate than in the registrational trials. Likewise, the baseline real-world Quality of Life was different from the patients enrolled in clinical trials due to many reasons including higher age at baseline which may also play a role in treatment decision
We are very pleased about this important success - and especially about the fact that we have achieved it together with our study centres.
The study was supported by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA.


