Neoadjuvant Initiation of Pembrolizumab Improves Outcomes vs Adjuvant Therapy Alone in Advanced Melanoma
Source: AJMC, March 2023
Treatment with neoadjuvant and adjuvant pembrolizumab (Keytruda) led to improved event-free survival (EFS) compared with adjuvant pembrolizumab alone for patients with resectable stage III or IV melanoma, a study published in The New England Journal of Medicine found.
The phase 2 trial (NCT03698019) randomized patients with clinically confirmed advanced, resectable melanoma to receive either 3 doses of neoadjuvant pembrolizumab followed by surgery and 15 doses of adjuvant pembrolizumab, or surgery followed by adjuvant pembrolizumab given every 3 weeks for approximately 1 year (18 doses total) or until disease recurrence or significant toxicity.
“This is the first clinical trial demonstrating that neoadjuvant therapy—that given before surgery—is superior to the same therapy given in the adjuvant setting—after surgery,” senior study author Antoni Ribas, MD, director of the Tumor Immunology Program at UCLA Jonsson Comprehensive Cancer Center, said in a statement.2 “This is because it is best to turn on the immune system inside the cancer before it is taken out with the surgery.”