BACKGROUND: Patients with regionally advanced melanoma are at high risk of distant failure and unlikely to be cured by surgery alone. Neoadjuvant therapy may provide benefit in these patients. OBJECTIVES: To evaluate our experience with neoadjuvant systemic therapy in high-risk stage III patients. METHODS: Retrospective review of patients with advanced stage III disease who received neoadjuvant therapy between August 2009 and August 2016 at Mayo Clinic Rochester. RESULTS: Twenty-three cases met our inclusion criteria, 16 with resectable disease and 7 with unresectable disease. No patients with resectable disease and one patient with borderline resectable disease progressed regionally, prohibiting surgical resection. Five of seven patients with unresectable disease were down-staged to a resectable state. Six of twenty-three (26%) had a CR and five are alive at last follow-up. Fifteen of twenty three patients (65%) progressed with a median progression free survival of 11 months; however, the 5 year overall survival estimate was 84%. CONCLUSIONS: Neoadjuvant systemic therapy is a reasonable approach for patients with advanced but resectable/borderline resectable disease and the risk of losing regional control is low. Our data also suggest some patients with unresectable disease will be converted to resectable and a complete clinical response to treatment can be obtained in approximately one quater of patients.
BACKGROUND:Patients with regionally advanced melanoma are at high risk of distant failure and unlikely to be cured by surgery alone. Neoadjuvant therapy may provide benefit in these patients. OBJECTIVES: To evaluate our experience with neoadjuvant systemic therapy in high-risk stage III patients. METHODS: Retrospective review of patients with advanced stage III disease who received neoadjuvant therapy between August 2009 and August 2016 at Mayo Clinic Rochester. RESULTS: Twenty-three cases met our inclusion criteria, 16 with resectable disease and 7 with unresectable disease. No patients with resectable disease and one patient with borderline resectable disease progressed regionally, prohibiting surgical resection. Five of seven patients with unresectable disease were down-staged to a resectable state. Six of twenty-three (26%) had a CR and five are alive at last follow-up. Fifteen of twenty three patients (65%) progressed with a median progression free survival of 11 months; however, the 5 year overall survival estimate was 84%. CONCLUSIONS: Neoadjuvant systemic therapy is a reasonable approach for patients with advanced but resectable/borderline resectable disease and the risk of losing regional control is low. Our data also suggest some patients with unresectable disease will be converted to resectable and a complete clinical response to treatment can be obtained in approximately one quater of patients.
Authors: Yana G Najjar; Dustin McCurry; Huang Lin; Yan Lin; Yan Zang; Diwakar Davar; Arivarasan Karunamurthy; Joseph J Drabick; Rogerio I Neves; Lisa H Butterfield; Marc S Ernstoff; Igor Puzanov; Joseph J Skitzki; Jennifer Bordeaux; IlaSri B Summit; Jehovana O Bender; Ju Young Kim; Beiru Chen; Ghanashyam Sarikonda; Anil Pahuja; Jennifer Tsau; Zeni Alfonso; Christian Laing; James F Pingpank; Matthew P Holtzman; Cindy Sander; Amy Rose; Hassane M Zarour; John M Kirkwood; Ahmad A Tarhini Journal: Clin Cancer Res Date: 2021-03-22 Impact factor: 13.801
Authors: Anna M Czarnecka; Krzysztof Ostaszewski; Aneta Borkowska; Anna Szumera-Ciećkiewicz; Katarzyna Kozak; Tomasz Świtaj; Paweł Rogala; Iwona Kalinowska; Hanna Koseła-Paterczyk; Konrad Zaborowski; Paweł Teterycz; Andrzej Tysarowski; Donata Makuła; Piotr Rutkowski Journal: Cancers (Basel) Date: 2021-12-27 Impact factor: 6.639