Neoadjuvant Immunotherapy vs Targeted Therapy: A Breakthrough in Stage III Melanoma

Understanding Neoadjuvant Immunotherapy and Its Impact

Neoadjuvant therapy has long been the standard of care for resectable stage IIIB melanoma and beyond. The latest findings reveal that neoadjuvant immunotherapy provides significant long-term benefits, especially for patients reaching a major pathological response (MPR).

Data Presentation

At the European Society of Medical Oncology (ESMO) Congress 2024, Dr. Georgina Long presented remarkable data from a cohort of 818 melanoma patients. The study highlights:

• 5-year relapse-free survival (RFS): Improved significantly, skyrocketing from 35% during standard observation protocols.
• Large Trials: The SWOG S1801 and NADINA trials confirmed major advancements with a 42% and 68% reduction in event risk, respectively.
• Patient Breakdown: Of the studied group, 95.3% underwent surgery, with 56.8% receiving adjuvant therapy.

Key Findings on Treatment Efficacy

Among the patients, those receiving neoadjuvant immunotherapy showed:

1. High Major Pathological Response Rates: 58% achieved MPR with immune checkpoint inhibitors.
2. Event-Free Survival: 74% over three years for those who received immunotherapy.
3. Overall Survival: Over 80% for all treatment categories, significantly higher for those with MPR.

Long emphasized that achieving MPR is essential for optimizing survival chances, signifying the critical role of therapy type in treatment outcomes.

Conclusion

This groundbreaking study reinforces that neoadjuvant immunotherapy is far more effective than targeted therapy in treating stage III melanoma, with implications for future treatment approaches.