Melanoma: Optimizing Selection of Adjuvant Therapy

Source: OncLive, September 2019

Dirk Schadendorf, MD, PhD: I disagree. I think what we have to keep in mind that in stage III disease, with just the surgery we are curing, is in roughly one-third of the patients. I mean, in multiple trials including the EORTC [European Organisation for Research and Treatment of Cancer] trial, we have seen after 5 years roughly one-third of the patients would not have needed any adjuvant treatments.

Alexander Eggermont, MD, PhD: No, two-thirds. Well, actually it’s 54% in ipilimumab trial who are cured at the 5-year mark, and it’s 65% who are without relapse at 5 years.

Dirk Schadendorf, MD, PhD: And one has to keep in mind that…if you look at the kinetics of relapses, for patients who had in the placebo arm—this is true for the old ipilimumab trial as well as for the COMBI-AD—most of the relapses do occur within the first 18 to 20 months. And you have a stabilization of the curve, even if the placebo adds to the patient population, which stabilizes after 24, 30 months. That’s what you see with all the other curves as well. That’s the reason why I don’t believe there will be a crossing of the curves with the checkpoint inhibitors.