Articles related to MELANOMA

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!

The results, presented during the virtual ESMO Congress 2021, will substantially change the population of patients with melanoma who undergo treatment in the adjuvant setting, according to Jason J. Luke, MD: “Patients with stage IIB/C melanoma have similar rates of recurrence and melanoma specific survival to those with stage IIIA/B disease. Despite this, adjuvant anti-PD-1 immunotherapy has only been available in standard practice for stage III disease. The results of KEYNOTE-716 will facilitate access to anti-PD-1 for stage IIB/C patients and, in a sense, level the playing field against melanoma.”

Dr. Kenneth Grossmann commented after presenting the results at the ASCO Annual Meeting in June: “The overall survival impact of pembrolizumab was likely influenced by effective post-relapse treatment, with standard-of-care patients receiving PD-1 blockade.” Dr. Grossmann then concluded that “single-agent anti-PD-1 antibody treatment should be a standard-of-care option for adjuvant treatment of high-risk resected melanoma,” and offered that the OS “trend of benefit is there.”

Lead author of the study, Dr. Ana Maria Arance, who presented the results over the summer at the ASCO Annual Meeting, commented: “With additional follow-up, lenvatinib plus pembrolizumab continues to show clinically meaningful, durable responses in patients with advanced melanoma with confirmed progression on a PD-1 or PD-L1 inhibitor given alone or in combination. These data support lenvatinib plus pembrolizumab as a potential regimen for this population of high unmet need.”

Presented at the virtual American Society of Clinical Oncology (ASCO) annual meeting, the findings from the S1404 clinical trial demonstrated that, although the PD-1 inhibitor pembrolizumab (Keytruda) came up short in both the intent-to-treat (ITT) population and PD-L1-positive subgroup, relapse-free survival (RFS) was significantly improved compared with those who received either ipilimumab (Yervoy) or high-dose interferon.