Melanoma Progression Following Adjuvant Therapy

Source: OncLive, September 2019

Sanjiv S. Agarwala, MD: Before we end adjuvant therapy, though, I have 1 quick question. People are getting adjuvant therapy now. Some of them will relapse, and they would require treatment. What do you consider to be refractory? The magic number is within 6 months for this, right? Six months beyond stopping adjuvant therapy relapse. Is that a treatment-naïve patient or not, Dr Eggermont? Is 6 months you’re feeling as well? Relapsing on treatment again?

Alexander Eggermont, MD, PhD: No, relapsing on treatment, there is obvious resistance. The 6 months is a best-guess type of period to work with in which you can restart with anti–PD-1 [programmed cell death protein 1] first. At least in BRAF wild-type patients, that’s what you would be doing, or you would give them the combo to enhance the chances.

Sanjiv S. Agarwala, MD: If a patient is BRAF-positive, and you give them BRAF-targeted therapy in the adjuvant setting and they relapsed 1 year later, would you give them immunotherapy or BRAF-targeted therapy again?