A single dose of a PD-1 inhibitor before surgery predicts outcomes in melanoma patients

Source: Medical Express, March 2019

A single dose of a PD-1 inhibitor before surgery for melanoma can put patients in remission. Researchers from the Abramson Cancer Center at the University of Pennsylvania, who documented this finding in the largest cohort of patients to be treated with anti-PD-1 drugs before surgery, also showed that immune responses brought on by this therapy can peak as early as seven days after treatment—much earlier than previous studies have shown. Patients in this study completed up to a year of anti-PD-1 therapy after surgery, and those with complete responses after the initial dose have remained cancer free for more than two years—the longest follow-up data to date for a trial evaluating this treatment approach for patients with melanoma. Further, researchers also identified patterns in the way melanoma that comes back after surgery adapts to develop resistance to PD-1 inhibitors, potentially paving the way for greater understanding of how best to help these patients. The findings appear in Nature Medicine today.

“Knowing so much earlier whether or not patients are responding to PD-1 inhibitors may give us the ability to guide them to the most appropriate therapy with the greatest chance for success," said the study’s lead author Alexander C. Huang, MD, an instructor of Hematology-Oncology in Penn’s Perelman School of Medicine and a Parker Bridge Scholar through the Parker Institute for Cancer Immunotherapy.

Melanoma is the deadliest form of skin cancer. The American Cancer Society estimates more than 96,000 new melanomas will be diagnosed in the United States in 2019, while about 7,200 people are expected to die from the disease this year. Currently, the standard of care in resectable melanoma includes surgeryfollowed by a year of drug treatment in select high risk patients, which can include immunotherapy like anti-PD-1 drugs.