Adjuvant treatment of melanoma
What is it?
Adjuvant treatment is defined as any therapy that is given in support of the main treatment in order to reduce the risk of recurrence and to improve the prognosis after surgery. For patients with early stage melanoma, there is no medical treatment. While for patients with metastatic stage there are several therapeutic options using target therapy (e.g. BRAF and MEK inhibitors) or immunotherapy (anti CTLA-4 and antiPD-1). In recent years, target therapies and immunotherapy can also be proposed in patients who have a high risk of developing metastases after removal of the primary tumor, in the setting of adjuvant treatment.
When is this procedure indicated?
Recent clinical trials have shown the therapeutic efficacy of MAPK pathway inhibitor target therapy and immunotherapy in surgically resected and disease-free patients. Therefore, adjuvant therapy is now considered a standard of care. In particular, in patients with BRAF wild type (i.e. without BRAF mutation) stage IIIA melanoma (with sentinel lymph node metastasis of at least 1 mm), IIIB, IIIC, IIID and IV NED adjuvant therapy with anti PD-1 should be considered as first treatment option. In patients with BRAF V600 mutation and stage IIIA melanoma (with sentinel lymph node metastasis of at least 1 mm), IIIB, IIIC and IIID adjuvant therapy with dabrafenib and trametinib should be considered as first treatment option. The option of clinical protocols using one of the above therapeutic strategies in combination with new drugs remains valid.
How is it performed?
The target therapy is administered through tablets that the patient can easily take at home, while the immunotherapy is administered intravenously.
Where do we treat it?
Our Departments
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