Practice-Changing Developments in Stage III Melanoma: Surgery, Adjuvant Targeted Therapy, and Immunotherapy

American Society of Clinical Oncology Educational Book
Ragini R KudchadkarAlexander C J van Akkooi

Abstract

In this article, we will focus on the practice-changing developments for stage III melanoma, from the use of the sentinel node (SN) biopsy to complete lymph node dissection (CLND) and upcoming adjuvant therapies. MSLT-1 (Multicenter Selective Lymphadenectomy Trial-1) was the first and only prospective randomized controlled trial to examine whether the SN biopsy has any notable melanoma-specific survival benefit (primary endpoint). MSLT-1 randomly assigned 2,001 patients to undergo either wide local excision (WLE) and an SN biopsy or WLE and nodal observation. Two prospective randomized controlled trials have examined the potential benefit for immediate CLND versus delayed CLND after sequential observation. Both the DECOG-SLT and MSLT-2 trials failed to demonstrate a notable benefit for immediate CLND; therefore, sequential follow-up with ultrasonography and a delayed CLND in the case of relapse should be considered the new standard of care. The CheckMate 238 study demonstrated a notable benefit for adjuvant nivolumab in terms of 18-month relapse-free survival (RFS) rates compared with high-dose adjuvant ipilimumab. Single-agent adjuvant BRAF inhibition has been examined and failed to improve RFS. However, the COMBI-AD study did...Continue Reading

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Apr 24, 2019·Journal of Medical Economics·Arielle G BensimonRaquel Aguiar-Ibáñez
Jun 13, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Claus GarbeUNKNOWN German Central Malignant Melanoma Registry and the European Organisation for Research and Treatment of Cancer
Mar 7, 2020·Melanoma Research·Subashini S GnanendranAndrew Miller
Jan 17, 2019·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Robyn D GartrellYvonne M Saenger
Jul 1, 2021·SAGE Open Medical Case Reports·Amanda HamiltonMark Zonta

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