2023-05-16 14:22:48
Recent studies indicate that neoadjuvant immunotherapy in melanoma patients leads to a significantly better pathological response. During a keynote session on At the 19th European Association of Dermato-Oncology Congress (EADO), encouraging findings on the benefits of neoadjuvant therapy were presented, which as a game changer could improve the outcome of many patients.
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In the adjuvant setting, immunotherapy is already standard in the treatment of patients with advanced melanoma. Promising data for neoadjuvant administration have now been presented, which indicate that perioperative administration significantly improves the therapeutic success compared to (sole) adjuvant therapy.
The randomized phase II study SWOG S1801 examined whether neoadjuvant immunotherapy in resectable melanoma actually produces a response to therapy or whether it merely delays the potentially curative operation and whether immune checkpoint blockade in the adjuvant setting makes more sense.1 A total of 345 patients with resectable stage IIIB-IV melanoma without brain metastases were included and randomized 1:1. 313 patients received adjuvant treatment (18 doses of pembrolizumab 200mg IV every 3 weeks) or neoadjuvant plus adjuvant treatment (3 cycles of neoadjuvant pembrolizumab and 15 cycles of adjuvant pembrolizumab). The primary endpoint was event-free survival (EFS). After a median follow-up of 14.7 months, EFS was significantly higher with neoadjuvant therapy plus adjuvant pembrolizumab than with adjuvant therapy (p=0.0015). “An event-free survival rate of 42 percent was recorded. This went hand in hand with no additional costs and no additional effort for the patients,” says Prof. Dr. Georgina Long from the Melanoma Institute in Sydney, Australia. Approximately 21 percent of those affected in the neoadjuvant arm achieved a pathologic complete response.
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#Neoadjuvant #Immuntherapie #beim #Melanom