Melanoma
CME
Charles H. Yoon, PhD, MD, FACS
Director of Surgery for Cutaneous Oncology & Melanoma
Dana-Farber Brigham Cancer Center, Boston, MA, USA
Boston, Massachusetts, United States
Disclosure(s): No financial relationships to disclose
Charles H. Yoon, PhD, MD, FACS
Director of Surgery for Cutaneous Oncology & Melanoma
Dana-Farber Brigham Cancer Center, Boston, MA, USA
Boston, Massachusetts, United States
Disclosure(s): No financial relationships to disclose
Merrick I. Ross, MD
Professor of Surgery - Chief, Melanoma Section
The University of Texas MD Anderson Cancer Center
Houston, TX, United States
Disclosure information not submitted.
Brian Gastman, MD
Surgical Director, Melanoma & High-Risk Skin Cancer Program
Cleveland Clinic Foundation, Cleveland, OH, USA, United States
Disclosure(s): No financial relationships to disclose
Jason J. Luke, MD, FACP
Director and Associate Professor
Cancer Immunotherapeutics Center, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
Pittsburgh, Pennsylvania, United States
Disclosure information not submitted.
Paolo A. Ascierto, MD
Director of the Unit of Melanoma, Cancer Immunotherapy and Innovative Therapy
Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale," Naples, Italy, United States
Disclosure information not submitted.
Georgina V. Long, AO, BSc PhD MBBS FRACP FAHMS
Co-Medical Director
Melanoma Institute Australia, The University of Sydney, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia, United States
Disclosure information not submitted.
Piotr Rutkowski, MD, PhD
Professor of Surgical Oncology
Maria Skłodowska-Curie National Research Institute of Oncology, United States
Disclosure information not submitted.
Muhammad Khattak, PhD
Clinical Professor
Fiona Stanley Hospital and Edith Cowan University, Perth, WA, Australia, United States
Disclosure information not submitted.
Michele Del Vecchio, MD, PhD
Head, Unit of Melanoma Medical Oncology
Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, United States
Disclosure information not submitted.
Luis de la Cruz Merino, PhD
Head of Department
Hospital Universitario Virgen Macarena, Seville, Spain, United States
Disclosure information not submitted.
Jacek Mackiewicz, PhD
Academician
Poznan University of Medical Sciences, Poznan, Poland, United States
Disclosure information not submitted.
Vanna Chiarion-Sileni, MD
Head of Melanoma & Esophageal Oncology Unit
Veneto Institute of Oncology IOV-IRCCS, Veneto, Italy, United States
Disclosure information not submitted.
Dirk Schadendorf, MD
Director of: Clinic for Dermatology
Comprehensive Cancer Center, Universitaetsklinikum Essen & German Cancer Consortium, Essen, Germany, United States
Disclosure information not submitted.
Matteo S. Carlino, BMedSc MBBS FRACP PhD
Clinical Senior Lecturer Medicine
Melanoma Institute Australia, The University of Sydney, Westmead and Blacktown Hospitals, Sydney, NSW, Australia, United States
Disclosure information not submitted.
Yujie Zhao, MD, PhD
Senior Scientist
Merck & Co., Inc., Rahway, NJ, USA, United States
Disclosure information not submitted.
Mizuho Fukunaga-Kalabis, PhD
Oncology Senior Clinical Director
Merck & Co., Inc., Rahway, NJ, USA, United States
Disclosure information not submitted.
Clemens Krepler, MD
Executive Director
Merck & Co., Inc., Rahway, NJ, USA, United States
Disclosure information not submitted.
Alexander M. M. Eggermont, MD, PhD
Chief Scientific Officer, Board of Directors
University Medical Center Utrecht, Netherlands & Comprehensive Cancer Center Munich, Germany, United States
Disclosure information not submitted.
Jeffrey E. Gershenwald, MD
The University of Texas MD Anderson Cancer Center
Houston, Texas, United States
Disclosure information not submitted.
.jpg "Vernon K. Sondak, MD (he/him/his) photo")
Vernon K. Sondak, MD (he/him/his)
Chair, Department of Cutaneous Oncology
Moffitt Cancer Center
Tampa, Florida, United States
Disclosure(s): Alkermes: Independent Contractor (Ongoing); AmLO Biosciences: Advisor (Ongoing), Consultant (Ongoing); Bristol-Myers Squibb: Advisor (Ongoing), Consultant (Ongoing); Genesis Drug Discovery & Development: Independent Contractor (Ongoing); Iovance Biotherapeutics: Advisor (Ongoing), Consultant (Ongoing); Merck & Co., Inc.: Advisor (Ongoing), Consultant (Ongoing); Neogene Therapeutics: Research Grant (Ongoing); Novartis Pharmaceuticals Corporation: Advisor (Ongoing), Independent Contractor (Ongoing); Regeneron: Advisor (Ongoing), Consultant (Ongoing); SkylineDx: Research Grant (Ongoing); Turnstone Biologics: Contracted Research (Ongoing), Research Grant (Ongoing); Ultimovacs: Consultant (Ongoing)
Of 976 patients assigned to treatment, 240 (24.6%) had primary melanoma of the head or neck, 321 (32.9%) the trunk, and 415 (42.5%) the extremities. Median follow-up was 26.9 months (range, 4.6-39.2). RFS and DMFS results by primary tumor location are presented in the table. Of 224 patients with disease recurrence (pembrolizumab, 91 [18.7%]; placebo, 133 [27.2%]), distant recurrence was the most common in patients with melanoma of the head or neck (pembrolizumab, 17 [3.5%]; placebo, 21 [4.3%]) and trunk (pembrolizumab, 18 [3.7%]; placebo, 27 [5.5%]), while locoregional recurrence was most common in patients with melanoma of the extremities (pembrolizumab, 24 [4.9%]; placebo, 22 [4.5%]). Lung was the most common site of first distant metastasis irrespective of primary site: head or neck (pembrolizumab, 8 [1.6%]; placebo, 17 [3.5%]), trunk (pembrolizumab, 11 [2.3%]; placebo, 19 [3.9%]), and extremities (pembrolizumab, 5 [1.0%]; placebo, 20 [4.1%]).
Conclusions: Consistent RFS and DMFS benefit was observed in patients with primary melanoma of the head or neck, trunk, and extremities, supporting the use of adjuvant pembrolizumab regardless of primary tumor location.