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Is Neoadjuvant Immunotherapy Effective in Treating High-Risk Melanoma?

By: Cordi Craig
Posted: Tuesday, December 11, 2018

A study conducted by a research team at The University of Texas MD Anderson Cancer Center suggests that neoadjuvant immune checkpoint blockade may be a feasible treatment option for patients with high-risk melanoma. The results, published in Nature Medicine, showed that patients achieved high response rates after neoadjuvant combination therapy, albeit high toxicity was observed. Rodabe N. Amaria, MD, and colleagues concluded that more robust studies are necessary to optimize treatment regimens and validate biomarkers.

“The advantage of a neoadjuvant approach in this setting is that it enables an interval evaluation of the tumor cells after therapy to determine the extent to which those tumor cells responded to the therapy in real time and predict which patients are likely to experience durable responses going forward,” stated senior coauthor Michael T. Tetzlaff, MD, PhD, in an MD Anderson press release.

The study randomly assigned 23 patients with high-risk resectable melanoma to receive neoadjuvant nivolumab monotherapy or combined ipilimumab plus nivolumab. Patients treated with combination therapy achieved higher response rates and higher rates of toxicity compared with those who received monotherapy. The combination group had an overall response rate of 73% and a pathologic complete response rate of 45%; however, 73% of these patients experienced severe adverse events. On the other hand, those treated with nivolumab monotherapy achieved a 25% overall response rate, and 8% of the study population experienced severe treatment-related adverse events.



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