Neoadjuvant Treatment Takes Center Stage for Patients with Resectable Melanoma

For patients with stage III melanoma, the goal is cure, but the risk for relapse is high. The standard approach has been complete surgical resection followed by adjuvant therapy — commonly, anti-PD-1 checkpoint-blocking antibodies (nivolumab and pembrolizumab) — to reduce the risk for recurrent disease by eliminating micrometastases. Early clinical data suggest that presurgical (i.e., neoadjuvant) treatment might yield better outcomes. In the industry-supported NADINA trial, the first randomized, phase 3 study testing this concept, researchers compared outcomes of 423 patients assigned either to two doses of neoadjuvant treatment (nivolumab plus ipilimumab) before surgery or to surgery upfront followed by adjuvant nivolumab alone (≤12 cycle…