Advances in adjuvant treatment for high‑risk BRAF mutated malignant melanoma

05/2019

MUDr. Radek Lakomý, Ph.D., MUDr. Alexandr Poprach, Ph.D.

Klinika komplexní onkologické péče, Masarykův onkologický ústav a LF MU, Brno

SUMMARY

Surgical excision is the curative treatment in most cases of early cutaneous melanoma. Prognosis of patients with high-risk primary melanoma or with nodal involvement remains poor. Impact of adjuvant interferon alfa on overall survival is limited. The recently published results from the randomized phase III trials with immunotherapy - anti-PD-1 antibodies (nivolumab, pembrolizumab) and with targeted therapy (dabrafenib + trametinib) are very promising. These new adjuvant treatment modalities are able significantly reduce the rate of disease recurrence. However, there are many unresolved questions. Especially, we do not know what is better in BRAF mutant melanoma, if targeted therapy or modern immunotherapy? We need reliable biomarkers of tumor progression and prognosis for better selection really high-risk patients and the optimal type of adjuvant treatment. The side effect profile of treatment and patient preference will play an important role in decision-making process.

Key words

melanoma, adjuvant treatment, new strategies