Melanoma

EORTC Melanoma Group changing daily practice for cancer patients

Recently, EORTC Melanoma group has presented and published new data that has shown improved outcomes for cancer patients. First of all, EORTC 1325/Keynote 054 study (adjuvant pembrolizumab vs. placebo after complete resection of high-risk stage III melanoma) which was presented at ASCO 2020, showed new recurrence free survival (RFS) data with median 3-year follow-up, confirming that the positive effect of pembrolizumab is durable with longer follow-up.

In addition, EORTC 1325 study presented, at the ESMO virtual Congress, the reduced risk of  Distant Metastasis Free Survival (DMFS) or death with adjuvant immunotherapy.

EORTC MG has, also, published a number of papers, Alexander van Akkooi, group chair, highlights the importance of these papers:

  • Evaluating the potential of relapse-free survival as a surrogate for overall survival in the adjuvant therapy of melanoma with checkpoint inhibitors (EJC)
    • This is an important paper, as it shows that RFS is a surrogate for OS in case of adjuvant immunotherapy for melanoma. This is an important methodological study, since RFS is not always a proxy for durable and meaningful benefit in OS.
  • Prognosis of Patients With Stage III Melanoma According to American Joint Committee on Cancer Version 8: A Reassessment on the Basis of 3 Independent Stage III Melanoma Cohorts (JCO)
    • This paper shows that the new AJCC 8th edition staging prognosis seems to be too positive, which does not seem realistic. In this independent European cohort ofall substages of melanoma, the prognosis seems slightly worse compared to AJCC, which is important information when counselling patients about their risks and the need for adjuvant treatment or participation into trials.
  • Adjuvant therapy with pegylated interferon-alfa2b vs observation in stage II B/C patients with ulcerated primary: Results of the European Organisation for Research and Treatment of Cancer 18081 randomised trial (EJC)
    • Although one might think that this prospective randomized trial with an ‘old’ therapy would not be worth reporting, it still confirms that patients with non-metastatic, but thick and ulcerated primary melanomas can benefit from PEG-IFN treatment. Might not be very relevant anymore in Europe, but certainly important findings for developing countries.
  • The EORTC-DeCOG nomogram adequately predicts outcomes of patients with sentinel node-positive melanoma without the need for completion lymph node dissection (EJC)
    • This study is relevant as it gives a prognostic risk assessment of melanoma patients with a positive Sentinel Node, without the need to perform extensive surgery (CLND). The latter clearly benefits patients’ Quality of life. This study was conducted by an early career investigator, who defended her PhD thesis in recent months.
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