Abstract #LBA6: Sapna Patel presented results of the P2 SWOGS1801 trial comparing adjuvant therapy (AT) (n=154) vs neoadjuvant therapy (NAT) (n=159) with pembrolizumab in patients with histologically confirmed, measurable, clinically detectable and resectable Stage IIIB-IV cutaneous,acral and mucosal melanomas without brain metastasis.
Results: After a median follow-up of 14.7 months, event free survival (EFS) was significantly higher on NAT compared to AT. 2-year EFS was 72% in the NAT arm vs49% in the AT arm. Benefit consistent across age, sex, performance status, stage, LDH, ulceration and BRAF status. Rates of adverse events were similar in both arms. In the NAT arm, available pathology reports (21%of patients) all showed complete pathologic response (0% viable tumor)on local review.
Thought leader reactions: Decidedly positive and “practice changing”for resectable stage 3-4 melanoma; neoadjuvant pembrolizumab led to significantly improved EFS vs. adjuvant with few AEs
Thought leaders also saw the data as demonstrating the broader value of neoadjuvant immunotherapy in melanoma
Encouraged by the results, some thought leaders suggested that similar comparisons should be made in other carcinomas (thoracic, uterine, bladder)
The P2 S1801 data demonstrates that neoadjuvantpembrolizumab followed by adjuvant pembrolizumab significantly improvesEFS in resectable stage 3-4 melanoma.Thought leaders in the space are very excited about the possibilities of neoadjuvant pembro (and other neoadjuvant immunotherapies) and keen to see similar trials in other cancers.