Adjuvant Systemic Therapy for High-Risk Melanoma Patients

摘要: Adjuvant therapy of cutaneous melanoma has advanced considerably since the approval of high-dose IFNalfa-2b with relapse free and overall survival in 1995 and the approval of Peg-IFN with improved relapse free survival in 2011. Immune checkpoint blockade in the adjuvant setting was first reported in 2015 with high-dose ipilimumab, showing improved relapse free and overall survival. This has been followed by the advent of anti-PD1 therapy with nivolumab and pembrolizumab and the first targeted BRAF and MEK inhibitor regimen for stage III disease in 2017, which have eclipsed prior therapies showing benefits of greater magnitude, and lesser toxicity. These have led to the development of studies that are currently directed at earlier stage IIB and IIC disease.