Moving on up 2.0.

Last week’s results of NeoCombi demonstrated impressive response rates with neoadjuvant dabrafenib and trametinib prior to surgery for stage III BRAF-mutated melanoma. You may recall that nearly every patient had some response and half had a complete response. In the similar phase 2 OpACIN-neo, neoadjuvant ipilimumab and nivolumab were tested in patients with resectable stage III melanoma. Patients were randomized to: A) two cycles of ipi/nivo with higher dose ipi; B) ipi/nivo with higher dose nivo; or, interestingly, C) two cycles each (sequentially) of higher dose ipi and higher dose nivo. The A and C regimens produced 40-50% rates of grade 3-4 toxicity compared to 20% with the B regimen. The corresponding pathologic complete response (pCR) rates for A, B, and C were: 47%, 57%, and 23%, respectively. Of note, no patients with pCR had relapse over the relatively short follow-up period. TBL: Two cycles of neoadjuvant ipilimumab (1 mg/kg) and nivolumab (3 mg/kg) appears to be both effective and tolerable for patients with resectable stage III melanoma. | Rozemann, Lancet Oncol 2019


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