Articles related to MELANOMA

168 adults with unresectable stage IIIC-IV melanoma with progression after 1 line of systemic treatment (not including ipilimumab) were randomly assigned to receive tumor-infiltrating lymphocyte therapy or ipilimumab. With a median follow-up of nearly 3 years, the median PFS was 7.2 months in the TIL arm and 3.1 months in the ipilimumab arm.

Resistance to immune checkpoint inhibitors is common. In a prior phase Ib study, the combination of talimogene laherparepvec (T-VEC) pembrolizumab demonstrated an encouraging complete response rate and acceptable safety profile in patients with advanced melanoma. In this phase III, randomized, double-blind, multicenter, international study, the combination of T-VEC-pembrolizumab did not statistically improve PFS or OS vs placebo-pembrolizumab. However, T-VEC-pembrolizumab demonstrated a numerical PFS improvement without new safety signals.

A 76-year-old Black woman arrives at the clinic for an evaluation of a slowly increasing bump on her face that she discovered about a year ago, which hasn’t itched, burnt, or caused any other pain. Is it a trichofolliculoma, a hypertrophic scar, basal cell carcinoma, or a cutis osteoma?

A randomized trial showed no significant difference in the rate of invasive melanoma between patients taking daily aspirin and those taking a placebo. There were slightly fewer melanoma events in the aspirin group than in the placebo group — 177 and 189, respectively — but the difference between the groups was not statistically significant (hazard ratio [HR], 0.94; 95% CI, 0.77-1.16; P =.58). Similarly, there were slightly fewer invasive melanoma events in the aspirin group than in the placebo group — 76 and 94, respectively — but the between-group difference was not significant (HR, 0.81; 95% CI, 0.60-1.10; P =.18).

Interest in immune-modulating neoadjuvant therapy for melanoma is growing. It is possible that BRAF/MEK inhibition will be more effective in the neoadjuvant than in the adjuvant setting because of the effect of the tumor biomass. And the benefits neoadjuvant therapy would offer in assessing biologic response assessment to treatment are significant. In this review the authors discuss the rationale for this treatment approach, summarize completed and ongoing neoadjuvant clinical trials, and contextualize these findings within the growing body of knowledge about targeted and immune checkpoint therapy.

Test your knowledge on this case study from JAMA Oncology! Full text available with registration, or you can access the Clinical Challenge from your institution. Good luck!