Neoadjuvant pembrolizumab may significantly improve the management of desmoplastic melanoma, increasing the likelihood of successful resection and reducing the need for further surgery or radiation therapy, according to the response data presented at the 2022 ASCO Annual Meeting, with the surgical considerations presented by Sondak et al at the 2023 Society of Surgical Oncology (SSO) International Conference on Surgical Cancer Care (Abstract 57). Results of the SWOG S1512 study demonstrated high rates of pathologic response and low rates of positive margins in patients with stage II to III desmoplastic melanoma who received neoadjuvant pembrolizumab. “Surgery was safely carried out after neoadjuvant anti–PD-1 immunotherapy, allowing for resection in virtually all patients,” said study co-investigator, Vernon K. Sondak, MD, Chair of the Department of Cutaneous Oncology at the H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, in an interview with The ASCO Post. “Moreover, pathologic response rates were very high compared with expectations from clinical trials in nondesmoplastic melanoma, where one to three doses of single-agent pembrolizumab was associated with a pathologic complete response rate of 20% to 30%.”
May 24, 2023