Addition of Neoadjuvant Pembrolizumab Improves EFS in Resectable Melanoma
Source: Onc Live, September 2022
Compared with adjuvant pembrolizumab (Keytruda) alone, the addition of neoadjuvant pembrolizumab significantly improved event-free survival (EFS) outcomes for patients with stage III-IV melanoma with a hazard ratio of 0.58 (95% CI, 0.39-0.87; P = .004), according to data from the phase 2 SWOG S1801 trial (NCT03698019).
The landmark 2-year EFS rate was 72% in the neoadjuvant arm (n = 159) compared with 49% in the adjuvant arm (n = 154). Tumor-related events—including disease progression, adjuvant therapy delays, and melanoma recurrence—occurred in 38 patients in the neoadjuvant arm and 67 patients in the adjuvant arm.
Twelve patients had disease progression that precluded surgery and 10 of patients had residual disease or developed a metastasis prior to adjuvant therapy in the neoadjuvant arm. Comparatively, 17 patients in the adjuvant arm experienced residual disease or developed metastasis prior to starting therapy.