Dr. Weber on Research Efforts Examining Neoadjuvant Approaches in Melanoma

Jeffrey S. Weber, MD, PhD, deputy director of NYU Langone’s Perlmutter Cancer Center; Laura and Isaac Perlmutter Professor of Oncology in the Department of Medicine at NYU Grossman School of Medicine; and the 2016 OncLiveGiant of Cancer Care® in Melanoma, discusses research efforts examining neoadjuvant approaches in melanoma.

Several exciting studies on neoadjuvant therapy in melanoma have recently been presented, says Weber. One such study was the phase 2 PRADO trial, which was led by Christian Blank, MD, and colleagues from the Netherlands Cancer Institute. In this trial, investigators enrolled patients with measurable, nodal, stage IIIB or IIIC disease and used an injectable device to mark the largest lymph node, Weber adds. Investigators then proceeded to administer neoadjuvant therapy. Following this, they performed a resection, only to look at the marked lymph node, Weber explains.

At the time of the lymphadenectomy, the marked lymph node reflected what happened in all the other lymph nodes perfectly, says Weber. Thus, these data suggest that, investigators can mark a lymph node and if it shows no signs of disease, they should not do anything further.

Additionally, an update from the OpACIN-neo trial, which was a prior study in which everyone had their lymph nodes out; none of them were marked. In this trial, patients were given 2 cycles of ipilimumab (Yervoy) and nivolumab (Opdivo) at flip doses and only a small number of relapses were reported with over 2 years of follow-up, Weber concludes.