Neoadjuvant Immunotherapy Superior to Targeted Therapy in Stage III Melanoma

Source: AJMC, August 2024

The standard of care for resectable stage IIIB or greater melanoma has been neoadjuvant therapy, and new data shows that neoadjuvant immunotherapy provides a long-lasting benefit to these patients, particularly if they achieve a major pathological response (MPR), which is a complete response or a near complete pathological response.

The results were presented by Georgina Long AO, PhD, MBBS, BSc, FRACP, FAHMS, co-medical director of Melanoma Institute Australia, at the European Society of Medical Oncology (ESMO) Congress 2024, held September 13 to 16 in Barcelona, Spain. The data was an updated pooled analysis and expanded cohort of the 2021 pooled analysis of 196 patients with melanoma who were treated with either neoadjuvant immunotherapy or BRAF/MEK targeted therapy.

The 5-year relapse-free survival (RFS) has improved significantly in this population in the last decade and a half, she explained from 35% when the standard approach was observation. Subsequent therapies “moved that needle a little more,” but there were 2 big trials in the last 2 years. The SWOG S1801 trial of neoadjuvant immunotherapy showed a 42% reduction in the risk of an event and the NADINA trial had a 68% reduction.
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