随机临床试验证明，辅助性抗程序性死亡 1（抗 PD1）抑制剂对切除的 IIB-IV 期黑色素瘤具有无复发生存获益。然而，迄今为止尚未观察到总体生存率的改善。此外，黑色素瘤的免疫治疗反应没有预测标记，因此仅根据病理和临床阶段向所有患者提供辅助治疗。此外，一年的治疗持续时间和慢性免疫相关不良反应的风险可能会对患者的生活质量产生负面影响。在这篇综述中，我们将尝试回答目前可用的 IIB-IV 期切除黑色素瘤辅助抗 PD1 治疗的数据是否足以使该策略适用于所有患者。我们还将讨论这种疗法对医疗保健系统预算的经济影响。最近的研究表明，癌症药物的高成本可能会影响全球范围内对这些药物的获取，从而引发患者和社会的可持续性问题。版权所有 © 2024 Elsevier B.V. 保留所有权利。

Randomized clinical trials demonstrated a recurrence-free survival benefit with adjuvant anti-programmed death-1 (anti-PD1) inhibitors of resected stage IIB-IV melanoma. However, no improvement in overall survival has been observed thus far. Furthermore, there are no predictive markers for immunotherapy response in melanoma, therefore adjuvant treatment is offered to all comers based exclusively on the pathological and clinical stages. Additionally, one year of treatment duration and the risk of chronic immune-related adverse effects may negatively impact patients´ quality of life. In this review, we will try to answer whether the currently available data on adjuvant anti-PD1 therapy of stage IIB-IV resected melanoma is sufficient to make this strategy available to all patients. We will also discuss the economic impact of this therapy on healthcare system budgets. Recent studies suggest that the high cost of cancer drugs may affect access to these agents globally by raising questions of sustainability for patients and society.Copyright © 2024 Elsevier B.V. All rights reserved.