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Adjuvant Therapy for Melanoma

  • Maiko Wada-OhnoEmail author
  • Takamichi Ito
  • Masutaka Furue
Skin Cancer (T Ito, Section Editor)
  • 136 Downloads
Part of the following topical collections:
  1. Topical Collection on Skin Cancer

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.

Keywords

Melanoma Adjuvant therapy Radiotherapy Immune therapy Targeted therapy Neoadjuvant therapy 

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

Notes

Compliance with Ethical Standards

Conflict of Interest

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

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Maiko Wada-Ohno
    • 1
    Email author
  • Takamichi Ito
    • 1
  • Masutaka Furue
    • 1
  1. 1.Department of Dermatology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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