Systemic adjuvant therapy for high-risk cutaneous melanoma
Cutaneous melanoma continues to increase in incidence and poses a significant mortality risk. Surgical excision of melanoma in its early stages is often curative. However, patients with resected stages IIB-IV are considered at high risk for relapse and death from melanoma where systemic adjuvant the...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-10-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359221134087 |
| _version_ | 1811335374318862336 |
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| author | Iyad Kobeissi Ahmad A. Tarhini |
| author_facet | Iyad Kobeissi Ahmad A. Tarhini |
| author_sort | Iyad Kobeissi |
| collection | DOAJ |
| description | Cutaneous melanoma continues to increase in incidence and poses a significant mortality risk. Surgical excision of melanoma in its early stages is often curative. However, patients with resected stages IIB-IV are considered at high risk for relapse and death from melanoma where systemic adjuvant therapy is indicated. The long-studied high-dose interferon-α was shown to improve relapse-free survival (RFS) and overall survival (OS) but is no longer in use. Adjuvant therapy with ipilimumab at 10 mg/kg (ipi10) demonstrated significant RFS and OS improvements but at a high cost in terms of toxicity, while adjuvant ipilimumab 3 mg/kg was shown to be equally effective and less toxic. More recently, the adjuvant therapy for resected stages III-IV melanoma in clinical practice has changed in favor of nivolumab, pembrolizumab, and BRAF-MEK inhibitors dabrafenib plus trametinib (for BRAF mutant melanoma) based on significant improvements in RFS as compared to ipi10 (nivolumab and pembrolizumab) and placebo (dabrafenib plus trametinib). For resected stages IIB-IIC melanoma, pembrolizumab achieved regulatory approval in the United States based on significant RFS benefits. In this article, we review completed and ongoing phase III adjuvant therapy trials. We also briefly discuss neoadjuvant therapy for locoregionally advanced melanoma. Finally, we explore recent studies on predictive and prognostic melanoma biomarkers in the adjuvant setting. |
| first_indexed | 2024-04-13T17:24:08Z |
| format | Article |
| id | doaj.art-6704324d779e44b6be84a67151ec5919 |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-04-13T17:24:08Z |
| publishDate | 2022-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-6704324d779e44b6be84a67151ec59192022-12-22T02:37:52ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592022-10-011410.1177/17588359221134087Systemic adjuvant therapy for high-risk cutaneous melanomaIyad KobeissiAhmad A. TarhiniCutaneous melanoma continues to increase in incidence and poses a significant mortality risk. Surgical excision of melanoma in its early stages is often curative. However, patients with resected stages IIB-IV are considered at high risk for relapse and death from melanoma where systemic adjuvant therapy is indicated. The long-studied high-dose interferon-α was shown to improve relapse-free survival (RFS) and overall survival (OS) but is no longer in use. Adjuvant therapy with ipilimumab at 10 mg/kg (ipi10) demonstrated significant RFS and OS improvements but at a high cost in terms of toxicity, while adjuvant ipilimumab 3 mg/kg was shown to be equally effective and less toxic. More recently, the adjuvant therapy for resected stages III-IV melanoma in clinical practice has changed in favor of nivolumab, pembrolizumab, and BRAF-MEK inhibitors dabrafenib plus trametinib (for BRAF mutant melanoma) based on significant improvements in RFS as compared to ipi10 (nivolumab and pembrolizumab) and placebo (dabrafenib plus trametinib). For resected stages IIB-IIC melanoma, pembrolizumab achieved regulatory approval in the United States based on significant RFS benefits. In this article, we review completed and ongoing phase III adjuvant therapy trials. We also briefly discuss neoadjuvant therapy for locoregionally advanced melanoma. Finally, we explore recent studies on predictive and prognostic melanoma biomarkers in the adjuvant setting.https://doi.org/10.1177/17588359221134087 |
| spellingShingle | Iyad Kobeissi Ahmad A. Tarhini Systemic adjuvant therapy for high-risk cutaneous melanoma Therapeutic Advances in Medical Oncology |
| title | Systemic adjuvant therapy for high-risk cutaneous melanoma |
| title_full | Systemic adjuvant therapy for high-risk cutaneous melanoma |
| title_fullStr | Systemic adjuvant therapy for high-risk cutaneous melanoma |
| title_full_unstemmed | Systemic adjuvant therapy for high-risk cutaneous melanoma |
| title_short | Systemic adjuvant therapy for high-risk cutaneous melanoma |
| title_sort | systemic adjuvant therapy for high risk cutaneous melanoma |
| url | https://doi.org/10.1177/17588359221134087 |
| work_keys_str_mv | AT iyadkobeissi systemicadjuvanttherapyforhighriskcutaneousmelanoma AT ahmadatarhini systemicadjuvanttherapyforhighriskcutaneousmelanoma |