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Adjuvant Therapy for Melanoma

  • Skin Cancer (T Ito, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

In recent years, the number of patients with malignant melanoma has continued to increase globally; surgery remains the first treatment option for patients with resectable melanoma. Adjuvant therapy for patients with stage III and IV melanoma following surgical resection has gradually been approved. After complete resection, these patients can probably derive significant benefit from adjuvant therapy. New treatments that improve the long-term survival of patients with unresectable advanced or metastatic melanoma are currently under evaluation in adjuvant therapy to increase relapse-free survival and overall survival. We here review several relevant clinical trials of radiotherapy, systemic immune therapies, molecular-targeted therapies, and neoadjuvant therapies in order to shed light on most suitable adjuvant therapy. The findings of this review include the following: The use of interferon-α2b will be restricted for patients with ulcerated primary melanoma in countries with no access to new drugs in adjuvant therapy. Ipilimumab should not be considered as the first-line therapy due to its lower efficacy and severe toxicity. The use of anti-programmed death-1 antibody would be a relevant adjuvant therapy for patients without BRAF mutation. If the BRAF mutation status is positive, the combination of dabrafenib and trametinib is a plausible option. The establishment of appropriate therapeutic planning and clinical endpoints in adjuvant therapy should affect the standard of care. The choice of optimal adjuvant therapy for individual patients is an important issue.

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Abbreviations

MAPK:

mitogen-activated protein kinase

OS:

overall survival

RFS:

relapse-free survival

RCT:

randomized controlled trial

FDA:

Food and Drug Administration

HR:

hazard ratio

IFN-α2b:

interferon-α2b

PD-1:

programmed cell death protein 1

ECOG:

Eastern Cooperative Oncology Group

EMA:

European Medicines Agency

AE:

adverse event

CTLA-4:

cytotoxic T lymphocyte-associated antigen 4

HRQoL:

health-related quality of life

PD-1:

programmed death-1

AJCC:

American Joint Committee on Cancer

DFS:

disease-free survival

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Authors and Affiliations

  1. Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, -1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Maiko Wada-Ohno MD, Takamichi Ito MD, PhD & Masutaka Furue MD, PhD

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  1. Maiko Wada-Ohno MD
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  2. Takamichi Ito MD, PhD
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  3. Masutaka Furue MD, PhD
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Correspondence to Maiko Wada-Ohno MD.

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Maiko Wada-Ohno, Takamichi Ito, and Masutaka Furue declare they have no conflict of interest.

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Wada-Ohno, M., Ito, T. & Furue, M. Adjuvant Therapy for Melanoma. Curr. Treat. Options in Oncol. 20, 63 (2019). https://doi.org/10.1007/s11864-019-0666-x

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