Neoadjuvant Pembrolizumab in Desmoplastic Melanoma
Source: The Asco Post, April 2023
Neoadjuvant pembrolizumab may significantly improve the management of desmoplastic melanoma, increasing the likelihood of successful resection and reducing the need for further surgery or radiation therapy, according to the response data presented at the 2022 ASCO Annual Meeting, with the surgical considerations presented at the 2023 Society of Surgical Oncology (SSO) International Conference on Surgical Cancer Care.
Results of the SWOG S1512 study demonstrated high rates of pathologic response and low rates of positive margins in patients with stage II to III desmoplastic melanoma who received neoadjuvant pembrolizumab. Study co-investigator, Vernon K. Sondak, MD, Chair of the Department of Cutaneous Oncology at the H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, called the results “astonishing” for this challenging patient population, suggesting that further evaluation of this treatment strategy is warranted.
“Surgery was safely carried out after neoadjuvant anti–PD-1 immunotherapy, allowing for resection in virtually all patients,” said Dr. Sondak. “Moreover, pathologic response rates were very high compared with expectations from clinical trials in nondesmoplastic melanoma, where one to three doses of single-agent pembrolizumab was associated with a pathologic complete response rate of 20% to 30%.”