In the last decade, we have seen a significant change in the therapeutic landscape for advanced melanoma.
Recently, results from two trials evaluating immunotherapy and targeted therapy in the adjuvant setting (completely resected stage III/IV) were published.
In this podcast, Teresa Amaral, member of the ESMO YOC, talks with Professor Jeffrey Weber, Professor of Oncology and Deputy Director of the Laura and Isaac Perlmutter Cancer Center, about the recent developments in adjuvant therapies for patients with melanoma.
Professor Weber also gives some insight on this data's impact on the treatment of real-world patients.
Currently, there is enough evidence to support adjuvant treatment in patients with resected Stage IIIB/C-IV melanoma. As for Stage II patients, this option should be considered in some selected cases (e.g. T ≥ 4mm with the presence of ulceration).
In both of the above-mentioned trials, patients were treated for a maximum of 12 months. Although a shorter treatment duration (e.g. 6 months) might result in the same benefit, it is unclear that a trial comparing 12 months to 6 months of therapy will be conducted to show equivalence, since it would be a very large trial requiring prolonged follow-up. So, for now, 12 months of adjuvant therapy is the standard. It is difficult to compare the results from both trials in patients with BRAF mutated melanoma since the populations treated were different but overlapping. Nonetheless, both therapies showed good results in the population of BRAF mutated stage III patients. What is clearly different is the safety profile and type of administration. Choosing one treatment over the other must also consider patient and physicians’ preferences. For patients that have a recurrence while receiving adjuvant therapy, changing from targeted therapy to immunotherapy and vice versa is probably the best approach."
You can hear the full interview also on the ESMO Open homepage: http://esmoopen.bmj.com/.
The related papers here: http://www.nejm.org/doi/full/10.1056/NEJMoa1708539 and http://www.nejm.org/doi/full/10.1056/NEJMoa1708539
http://www.nejm.org/doi/full/10.1056/NEJMoa1709030.
