New approaches in the treatment of stage II and III melanoma in the context of current research results

02/2020

MUDr. Eugen Kubala

Onkologická klinika 1. LF UK a Thomayerovy nemocnice, Praha

SUMMARY

The successful journey continues. After success in advanced and metastatic melanoma, melanoma treatment has been transferred to adjuvant therapy. It is essential to determine early stages of melanoma suitable for adjuvant treatment. According to the new classification, the prognosis for stages IIB and IIC is worse than for stage IIIA. This group of patients is currently denied adjuvant therapy and we are awaiting the results of ongoing trials. Because the risk of disease relapse is high, between 40 and 60%, the aims of current research to move adjuvant therapy to the stage II. The Keynote 716 study (MK 3475-716 - NCT03553836) sought to determine whether adjuvant therapy with pembrolizumab at risk stages IIB and IIC would delay the relapse of the disease. The focus of the main studies of targeted treatment of COMBI AD and immunotherapy EORTC 18071, CheckMate-238, Keynote 054 was the stage III. The question is not whether to treat, but what treatment to start especially for melanoma with BRAF V600 mutation. Adjuvant treatment at this stage has shown a clear benefit and its use is undoubted. Unfortunately, we are not clear about subsequent treatment at relapse during or after adjuvant treatment.

Key words

adjuvant treatment, nodal staging, targeted treatment, immunotherapy