Neoadjuvant Therapy NCCN Recommendations Take the Melanoma Field in a New Direction
Source: OncLive, October 2024
Douglas B. Johnson, MD, MSCI, unpacks NCCN guideline updates in melanoma, detailing how neoadjuvant and TIL therapies have been notable advancements.
Data from multiple practice-changing studies demonstrating the efficacy of neoadjuvant therapy led to several changes to the NCCN Clinical Practice Guidelines in Oncology for melanoma in 2024, and ensuring multidisciplinary communication is strong with these critical changes will be key, according to Douglas B. Johnson, MD, MSCI. Johnson, who is vice chair of the Melanoma NCCN Guidelines, also added that the addition of the first approved tumor-infiltrating lymphocyte (TIL) therapy, lifileucel (Amtagvi), represents a major advancement from 2024 in the refractory setting.
“In the neoadjuvant setting, it’s important for community oncologists to work with their surgical oncologists and make sure they’re aware of the new guideline changes. In the past, our surgeons would oftentimes do a fantastic surgery and then refer to us. That was the workflow where we wouldn’t see the patient until after surgery, and that was appropriate at that time, but it’s changed,” Johnson said in an interview with OncLive®. “If a patient has a palpable lymph node, an in-transit lesion, or even isolated stage IV [disease], in most cases they shouldn’t go to surgery first. They should see us for a few doses of neoadjuvant therapy and then undergo surgery.”