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Neoadjuvant Therapy in Melanoma: Where Are We Now?

  • MELANOMA (DB JOHNSON AND DY WANG, SECTION EDITORS)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purposeof Review

This review summarizes the current state of neoadjuvant immunotherapy and targeted therapy for locoregionally advanced melanoma.

Recent Findings

Melanoma systemic therapy has witnessed major advances with the development of immune checkpoint inhibitors and molecularly targeted therapy that have been translated into the neoadjuvant setting in managing locoregionally advanced disease. PD1 blockade as monotherapy and combined with CTLA4 blockade or LAG3 inhibition has demonstrated major improvements in reducing the risk of relapse and death that were associated with high pathologic response rates. Similar results were reported with BRAF-MEK inhibition for BRAF mutant melanoma with high pathologic response rates that appear to be less durable compared to immunotherapy. More importantly, in a recent randomized trial, event-free survival was significantly improved with neoadjuvant pembrolizumab compared to standard surgery and adjuvant therapy.

Summary

Neoadjuvant therapy has become the standard of care for locoregionally advanced melanoma. Ongoing studies will define the most optimal combination regimens.

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Data Availability

Data sharing not applicable-no new data. 

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Vanderbilt University, Nashville, TN, USA

    Mariam Saad

  2. Departments of Cutaneous Oncology and Immunology, H. Lee Moffitt Cancer Center and Research Institute and University of South Florida, 10920 McKinley Dr. Tampa, Tampa, FL, 33612, USA

    Ahmad A. Tarhini

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Correspondence to Ahmad A. Tarhini.

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Human and Animal Rights and Informed Consent

This is a review article of published literature, expert analysis, and recommendations. It does not contain new studies. Reported studies performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines) as previously reported.

Conflict of Interest

Mariam Saad declares no conflict of interest. Ahmad Tarhini reports contracted research grants with institution from Bristol Myers Squib, Genentech-Roche, Regeneron, Sanofi-Genzyme, Nektar, Clinigen, Merck, Acrotech, Pfizer, Checkmate, OncoSec; personal consultant/advisory board fees from Bristol Myers Squibb, Merck, Easai, Instil Bio Clinigin, Regeneron, Sanofi-Genzyme, Novartis, Partner Therapeutics, Genentech/Roche, BioNTech, Concert AI, AstraZeneca outside the submitted work.

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Saad, M., Tarhini, A.A. Neoadjuvant Therapy in Melanoma: Where Are We Now?. Curr Oncol Rep 25, 325–339 (2023). https://doi.org/10.1007/s11912-023-01369-6

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