French dermatologists' opinions and practices with regard to adjuvant therapy in stage III melanoma

BackgroundIn 2018, the European Medicines Agency authorized adjuvant therapy for patients with resected stage III melanoma.ObjectivesThe objective of the present study (performed in France) was to assess dermatologists' and oncologists' opinions and prescribing habits in this context.MethodsFrom 28 May to 8 June 2021, we performed an online survey of members of the French Groupe de Cancérologie Cutanée (GCC) skin cancer interest group.ResultsThirty-eight practitioners replied to the survey. For BRAF-mutant melanoma, 58% of the practitioners favoured immunotherapy (IT). If they themselves were to suffer from melanoma with a BRAFV600 mutation, 65% would choose IT for stage IIIB disease, and 72% would choose IT for stage IIID disease. For stage IIIA melanoma with a positive sentinel lymphatic node (SLN) biopsy <1 mm, 32% of the practitioners stated that they would not offer adjuvant therapy. Sixty-three percent of the practitioners disagreed with restricting adjuvant therapy to patients aged 80 and over. Although 84% of the practitioners were aware of the cost of adjuvant therapy, 81% did not take account of this factor in their treatment decisions. In patients with a positive SLN biopsy, 90% of the practitioners stated that they would not recommend complete lymph node dissection. Eighty percent of the surveyed practitioners discussed the potential impact of treatments on fertility, respectively with their male and female patients. Of these practitioners, 63%–72% (depending on the situation) stated that they would recommend fertility preservation procedures.ConclusionsThis work points out some debated issues among French dermatologists and oncologists regarding adjuvant therapy in stage III melanoma. Our present results might prompt more comprehensive studies of these particular points.