The Role of Neoadjuvant Immunotherapy Advances in Resectable Stage III Melanoma
Source: Pharmacy Times, July 2024
NADINA trial results support a new standard of care for these patients.
Melanoma is the fifth most common type of cancer in the United States, with an estimated 100,640 new cases and 8290 deaths in 2024. The majority of patients will present with localized disease, of which surgical resection is the treatment of choice and is associated with approximately 90% long-term survival in stage I disease.2 To reduce the risk of recurrence, adjuvant immunotherapy or targeted therapy is indicated in patients with stage IIB or higher resectable disease. However, despite surgical resection and adjuvant therapy, the relapse rate is as high as 40% within the first 2 years in patients with stage III melanoma.
Neoadjuvant administration of immunotherapy has become appealing in melanoma because of several hypothesized benefits over adjuvant therapy, including its ability to activate more antitumor T cells before resection of the bulk of the tumor. With adjuvant therapy, the measurable tumor has already been excised, whereas neoadjuvant therapy allows for the delivery of immunotherapy when the tumor is still present, allowing for increased proliferation and maturation of intratumoral T cells.