Dr. Tarhini Discusses Adjuvant Therapy for Melanoma

Ahmad Tarhini, MD, PhD, director, Melanoma and Skin Cancer Program, Center for Immuno-Oncology Research, Cleveland Clinic, discusses adjuvant therapy for patients with melanoma.

Adjuvant therapy for melanoma is used in patients who are considered high risk for relapse or death, says Tarhini. For these patients, there is an indication to administer systemic treatment, which historically has been with interferon alpha. In 2015, ipilimumab (Yervoy) was approved for the adjuvant treatment of patients with melanoma. In April 2018, the FDA approved the combination of dabrafenib (Tafinlar) and trametinib (Mekinist) for the adjuvant treatment of patients with BRAF V600E— or V600K–positive stage III melanoma following complete resection.

The problem with the currently available adjuvant treatment options have been the toxicity profiles, says Tarhini. Specifically, the cumbersomeness of interferon can negatively affect quality of life. Due to the toxicities, the survival advantage of interferon has been taken into question. In a recent analysis, Tarhini says that only a minority of patients will go onto receive adjuvant therapy after lymph node surgery—either with interferon or ipilimumab.