Georgina Long, MD, PhD, Melanoma Institute Australia, Sydney, Australia, discusses updated pooled analysis results from the International Neoadjuvant Melanoma Consortium which compared long-term survival of neoadjuvant immunotherapy and BRAF/MEK targeted therapy in patients with advanced melanoma. Results demonstrated that neoadjuvant immunotherapy provides lasting survival in this patient population. 

Dr Long presented these results at the 2024 European Society of Medical Oncology (ESMO) Congress in Barcelona, Spain. 

Transcript: 

My name is Professor Georgina Long from Melanoma Institute Australia in the University of Sydney. I'm here at ESMO 2024 in Barcelona, Spain with many colleagues and friends which is a great place to be because there is exciting data being presented.

I presented the neoadjuvant pooled analysis for melanoma yesterday. What we showed was when we included 818 patients from around the world, both from clinical trials and non-trials who had stage 3 or 4, but mainly stage 3 (95% of the patients had stage 3 resectable melanoma) and analyzed how those patients went by groups of treatment we found patients who had immune checkpoint inhibitors alone, single-agent, or in combination did the best in terms of the event-free survival, that's defined as progression before surgery, recurrence after surgery, or death, as well as for the overall survival. When we looked at patients who had a major pathological response, that's defined in an article from Annals of Oncology 2018 from the International Neoadjuvant Consortium, those with a complete pathological response or a near complete pathological response, did very well on immune checkpoint inhibitors with an over-90% relapse-free survival after surgery. 

The take home message from that pooled analysis of 818 patients, predominantly patients on immune checkpoint inhibitors, was that immune checkpoint inhibitors compared with things like BRAF-targeted therapies or targeted therapies combined with immune checkpoint inhibitors, pure immune checkpoint inhibitors did the best in terms of the event-free survival overall. In terms of the rate of major pathological response, it was 50% and above and in terms of long-term outcome after a major pathological response. In contrast, BRAF and MEK inhibitors seem to do the same as they would do in the adjuvant setting, there does not seem to be a neoadjuvant benefit, nor did they do as well as immune checkpoint inhibitors. 

Source: 

Long GV, Blank CU, Amaria RN, et al. Long-term survival with neoadjuvant therapy in melanoma: Updated pooled analysis from the International Neoadjuvant Melanoma Consortium (INMC). Presented at 2024 ESMO Congress. September 13-17, 2024. Abstract LBA41