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•स्क्रिनमा देखिने चुरोट: सुर्तीजन्य हानि न्यूनीकरण नीतिमा दक्षिण एसियाले अझै के छुटाइरहेको छ•नेपालमा पिसाब नलीको संक्रमण र एन्टिबायोटिक प्रतिरोधको बढ्दो संकट•Frontline Perspectives on Nursing Leadership in Nepal•Protecting the Smallest Lungs from the Hidden Grip of RSV in Kathmandu•The Heavy Burden of Bullying on Student Wellbeing in Nepal•The Emerging Landscape of Thyroid Health in Central Nepal•How a Recent Western Nepal Study is Redefining Anemia Diagnosis•How H. Pylori is Impacting the Health of Karnali’s High-Altitude Communities•Sweet Poison, Bitter Reality: The Unseen Diabetes Epidemic Among Nepal’s Youth•How Missing Checklists and Protocols are Costing Lives in Nepal’s ERs•स्क्रिनमा देखिने चुरोट: सुर्तीजन्य हानि न्यूनीकरण नीतिमा दक्षिण एसियाले अझै के छुटाइरहेको छ•नेपालमा पिसाब नलीको संक्रमण र एन्टिबायोटिक प्रतिरोधको बढ्दो संकट•Frontline Perspectives on Nursing Leadership in Nepal•Protecting the Smallest Lungs from the Hidden Grip of RSV in Kathmandu•The Heavy Burden of Bullying on Student Wellbeing in Nepal•The Emerging Landscape of Thyroid Health in Central Nepal•How a Recent Western Nepal Study is Redefining Anemia Diagnosis•How H. Pylori is Impacting the Health of Karnali’s High-Altitude Communities•Sweet Poison, Bitter Reality: The Unseen Diabetes Epidemic Among Nepal’s Youth•How Missing Checklists and Protocols are Costing Lives in Nepal’s ERs

Five-year survival with neoadjuvant therapy in melanoma: updated pooled analysis from the International Neoadjuvant Melanoma Consortium (INMC).

Researchers

Georgina V Long, Inês Pires da Silva, Kristen A Perry, Jurriaan Romano, Serigne N Lo, Piyush Grover, Paolo A Ascierto, Rodabe N Amaria, Tina J Hieken, Caroline Robert, Lucie Heinzerling, Shahneen Sandhu, Milton Barros, Tara C Mitchell, Zeynep Eroglu, Igor V Samoylenko, Lukas Flatz, Céleste Lebbé, Douglas B Johnson, Piotr Rutkowski, Eva Muñoz-Couselo, Omid Hamid, Claudia Trojaniello, Domenico Mallardo, Matthew S Block, Naima Hammoudi, Naima Benannoune, Dirk Tomsitz, Yang Wang, Cigdem Dinckal, Angelina Kuzmenko, Andrea Forschner, Matteo S Carlino, Mathilde Jalving, Michael A Postow, P Francesco Ferrucci, Ellen Kapiteijn, Astrid A M van der Veldt, Karijn P M Suijkerbuijk, Laetitia da Meda, Hannah Burnette, Anna Czarnekca, Inderjit Mehmi, Geke Hospers, Sarah Lochrin, Alexander C J van Akkooi, Hussein A Tawbi, Elizabeth M Burton, Michael T Tetzlaff, Bart A van de Wiel, Robert V Rawson, Christian U Blank, Alexander M Menzies

Abstract

Neoadjuvant immune checkpoint inhibitors (ICIs) are standard of care for resectable stage IIIB-D melanoma, but knowledge gaps remain regarding optimal treatment type, long-term survival, postsurgical management and clinical, histopathological or molecular subgroups. We analyzed 1,038 patients treated with neoadjuvant ICIs (n = 735), BRAF and MEK inhibitors (BRAF/MEKis; n = 119) or ICI plus any targeted therapy (ICI + TT; n = 184) from 26 international sites in both trial (755, 72.7%) and nontrial (283, 27.3%) settings. ICI regimens included anti-programmed cell death protein 1 (PD-1) alone (PD-1 alone; n = 242) and anti-PD-1 plus other immuno-oncology agent(s) (PD-1 + IO; n = 489). Outcomes included major pathological response (MPR), recurrence-free survival (RFS) and overall survival (OS). An MPR was achieved in 57.8% of patients with ICIs, 51.4% with BRAF/MEKis and 44.6% with ICI + TT. PD-1 + IO elicited higher MPR rates than PD-1 alone (61.4% versus 49.5%). The 5-year RFS rate was 61.0% with PD-1 alone, 73.9% with PD-1 + IO, 37.4% with BRAF/MEKis and 76.4% with ICI + TT; the 5-year OS rates were 83.3%, 87.5%, 69.8% and 83.9%, respectively. ICI-treated patients with MPR had 5-year OS rates of 98.8% with PD-1 alone and 97.9% with PD-1 + IO and gained no benefit from continuing ICIs into the adjuvant setting. Neoadjuvant ICIs were active in BRAF-mutant melanoma (MPR, 46.3%), acral melanoma (38.1%), in-transit metastases (66.7%) and oligometastases (41.2%), although subgroup sizes and relative effectiveness varied. Survival outcomes were excellent with neoadjuvant ICIs, particularly in patients achieving MPR, but poor with BRAF/MEKis and mixed with ICI + TT. Predictive biomarker-driven trials, effective adjuvant strategies and subgroup-specific research are needed for nonresponders.
Source: PubMed (PMID: 42823486)View Original on PubMed