Dr. Patel on the Neoadjuvant Administration of Pembrolizumab in Advanced Melanoma

Sapna Patel, BA, MD, medical oncologist, associate professor, director of the Uveal Melanoma Program and Melanoma Fellowship Program, The University of Texas MD Anderson Cancer Center, discusses the neoadjuvant administration of pembrolizumab (Keytruda) in advanced melanoma.

The phase 2 SWOG 1801 trial (NCT03698019) evaluated pembrolizumab both before and after surgery in patients with high-risk melanoma compared with pembrolizumab administered in the adjuvant setting only.

At a median follow up of 14.7 months, 104 events were reached prompting investigators to conduct the primary analysis, Patel says. The end point of event-free survival (EFS) was stronger in the neoadjuvant arm vs the adjuvant arm with a hazard ratio of 0.58 and a P value of 0.004. The benefit in favor of the neoadjuvant regimen was seen across all key subgroups, including age, gender, lactate dehydrogenase status, alteration of the primary melanoma and stage, and BRAF mutation status, Patel adds.

To account for a difference in timing of assessments and timing to reaching adjuvant therapy, patients who did not reach adjuvant therapy were assigned an EFS of 84 days, Patel concludes.