Neoadjuvant Anti-PD-1 Predicts Melanoma Outcomes

Source: Medpage Today, March 2019

A single dose of neoadjuvant anti-programmed cell death 1 (PD-1) therapy was effective in some stage IIIB/C and IV melanoma patients, leading to a disease-free survival (DFS) rate of 63% and an overall survival (OS) rate of 93% at 2 years, a small phase Ib clinical trial found.

Alexander C. Huang, MD, of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues, observed a very rapid immune response in peripheral blood after PD-1 blockade, with T cell re-invigoration peaking just 7 days after treatment. Complete or major pathologic response occurred in about 30% of patients within 3 weeks.

“Notably, these patients with early complete or major pathological tumor response have 100% DFS at 24 months," Huang and co-authors wrote in Nature Medicine. In contrast, those whose tumors showed poor pathological response at surgery had a poor prognosis, with a more than 50% risk of recurrence despite adjuvant therapy.