Neoadjuvant Immunotherapy for Stage III Melanoma Emerges as New Standard of Care
Source: Targeted Oncology, August 2023
The phase 2 SWOG S1801 trial showed a 42% reduction in 2-year event-free survival for neoadjuvant-adjuvant vs adjuvant-only pembrolizumab for resectable stage IIIB-D/IV melanoma.
Emerging neoadjuvant therapy has resulted in a strategy shift for high-risk operable melanoma. This change in the treatment landscape is supported by many clinical trials including the randomized phase 2 SWOG S1801 trial (NCT03698019), which reported a 42% reduction in 2-year event-free survival for neoadjuvant-adjuvant vs adjuvant-only pembrolizumab (Keytruda) for resectable stage IIIB-D/IV melanoma (72% v 49%; HR, 0.58; P = .004).
Checkpoint inhibitor immunotherapies, including PD-1 and CTLA-4, and BRAF/ MEK targeted therapies play key roles in the neoadjuvant arena and have substantially improved melanoma survival, with 5-year survival rates of 30% to 50%.1 These results have led to the development of checkpoint immunotherapy and targeted therapies in both the adjuvant and neoadjuvant settings.