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Soo Park, MD
Soo Park, MD
Posted: Monday, October 7, 2024
Neoadjuvant combination immunotherapy confers a long-term survival benefit in patients with resectable stage IIIB or higher melanoma, particularly if they achieve a major pathologic response, based on updated data from an expanded cohort of the 2021 International Neoadjuvant Melanoma Consortium (INMC) pooled analysis. At the European Society for Medical Oncology (ESMO) Congress 2024 (Abstract LBA41), Georgina V. Long, MD, PhD, of the Melanoma Institute Australia and the University of Sydney, and colleagues added that those without a pathologic complete response will need alternative approaches.
In brief, the 2021 INMC pooled analysis focused on 192 patients. The present analysis was conducted using clinical, radiographic, histopathologic, and survival data from 818 clinical trial (77%) and real-world (23%) patients; follow-up data were provided for a median of 3 years. The patients were treated with neoadjuvant immunotherapy (N = 610; PD-1 inhibition alone: n = 169; PD-1 plus CTLA-4 inhibition: n = 351; PD-1 plus LAG-3 inhibition: n = 59; PD-1 inhibition plus another immunotherapy: n = 27; CTLA-4 inhibition alone: n = 4), BRAF/MEK inhibitor therapy (N = 88), or immunotherapy plus targeted therapy (N = 120).
The investigators reported that the major pathologic response and recurrence-free survival rates for patients who underwent therapeutic lymph node dissection or index node resection, as well as the event-free survival rates for the total population, differed by treatment regimen; those who were treated with immunotherapy demonstrated the highest rates. The overall survival data remain immature.
In the immunotherapy cohort, the 3-year event-free survival rates were 64% with PD-1 inhibition alone, 76% with PD-1 plus CTLA-4 inhibition, and 82% with PD-1 plus LAG-3 inhibition. The 1.5-year event-free survival rate was 95% in those who were treated with a PD-1 inhibitor plus another immunotherapeutic agent (median follow-up = 1.7 years).
Disclosure: For full disclosures of the study authors, visit cslide.ctimeetingtech.com.
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