Adjuvant therapy for stage II melanoma: the need for further studies
Authors
Lee, Rebecca JMandala, M.
Long, G. V.
Eggermont, A. M. M.
van Akkooi, A. C. J.
Sandhu, S.
Garbe, C.
Lorigan, Paul C
Affiliation
The Christie NHS Foundation Trust, Department of Medical Oncology, Manchester, UKIssue Date
2023
Metadata
Show full item recordAbstract
Immunotherapy with checkpoint inhibitors has revolutionised the outcomes for melanoma patients. In the metastatic setting, patients treated with nivolumab and ipilimumab have an expected 5-year survival of> 50%. For patients with resected high-risk stage III disease, adjuvant pembrolizumab, nivolumab or dabrafenib and trametinib are associated with a significant improvement in both relapse-free survival (RFS) and distant metastasis-free survival (DMFS). More recently neoadjuvant immunotherapy has shown very promising outcomes in patients with clinically detectable nodal disease and is likely to become a new standard of care. For stage IIB/C disease, two pivotal adjuvant trials of pembrolizumab and nivolumab have also reported a significant improvement in both RFS and DMFS. However, the absolute benefit is low and there are concerns about the risk of severe toxicities as well as long-term morbidity from endocrine toxicity. Ongoing registration phase III trials are currently evaluating newer immunotherapy combinations and the role of BRAF/MEK-directed targeted therapy for stage II melanoma. However, our ability to personalise therapy based on molecular risk stratification has lagged behind the development of novel immune therapies. There is a critical need to evaluate the use of tissue and blood-based biomarkers, to better select patients that will recur and avoid unnecessary treatment for the majority of patients cured by surgery alone.Citation
Lee R, Mandala M, Long GV, Eggermont AMM, van Akkooi ACJ, Sandhu S, et al. Adjuvant therapy for stage II melanoma: the need for further studies. European journal of cancer (Oxford, England : 1990). 2023 May 8:112914. PubMed PMID: 37301717. Epub 2023/06/11. eng.Journal
European Journal of CancerDOI
10.1016/j.ejca.2023.05.003PubMed ID
37301717Additional Links
https://dx.doi.org/10.1016/j.ejca.2023.05.003Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1016/j.ejca.2023.05.003
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