LONG-TERM stage IV melanoma survivors reported persistent physical, psychological, and financial challenges after treatment with immune checkpoint inhibitors and targeted therapies, according to a multicentre survey of 296 patients across Austria, Germany, and Switzerland. The study defined long-term survivors as patients living more than five years after a stage IV diagnosis.
Between April 2024 and May 2025, researchers surveyed patients from 40 centres within the German Dermatologic Cooperative Oncology Group and patient support groups. The online survey assessed treatment-related adverse events (TRAEs), financial burden, and psychosocial distress using validated tools and disease-specific questions.
Approximately 80% of participants had received immune checkpoint inhibitors (ICI) at some point, while around 27% had received targeted therapy (TT). Approximately 30% had previously experienced brain metastases.
Around 40% of participants reported persistent TRAEs and distress levels above the threshold. Among patients who had undergone radiotherapy or surgery, approximately 30% reported persistent TRAEs associated with either treatment.
Cognitive deficits following cerebral radiotherapy and lymphoedema after surgery were the most frequently reported complaints. Persistent TRAEs associated with systemic anti-tumour therapy were significantly associated with elevated distress, with an odds ratio (OR) of 1.99 (p=0.025).
The findings indicate that long-term survival after stage IV melanoma can be accompanied by ongoing treatment-related effects that extend beyond active disease management. The association between persistent systemic treatment effects and distress also highlights the potential psychological burden of long-term treatment consequences.
Financial challenges were reported by approximately 23% of participants. Among patients aged 65 years or younger, 62% remained in employment at the time of the survey, with half working reduced hours. Among retired participants, 44% reported retiring early because of melanoma.
The researchers concluded that a substantial proportion of long-term stage IV melanoma survivors experience persistent physical, psychosocial, and financial challenges. They proposed dedicated survivorship programmes incorporating validated screening alongside vocational, financial, and psychological counselling to address these unmet needs.
Reference
Reitmajer M et al. Beyond the surface of long-term survival in stage IV melanoma: a multicenter cross-sectional study. Br J Dermatol. 2026;DOI: 10.1093/bjd/ljag374.
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