Preliminary results from the international neoadjuvant melanoma consortium (INMC).

Authors

null

Alexander M. Menzies

Melanoma Institute Australia, Royal North Shore Hospital, The University of Sydney, Sydney, Australia

Alexander M. Menzies , Elisa A. Rozeman , Rodabe Navroze Amaria , Richard A. Scolyer , Michael T. Tetzlaff , Alexander Guminski , Michael A. Davies , Christian U. Blank , Jennifer Ann Wargo , Georgina V. Long

Organizations

Melanoma Institute Australia, Royal North Shore Hospital, The University of Sydney, Sydney, Australia, Netherlands Cancer Institute, Amsterdam, Netherlands, The University of Texas MD Anderson Cancer Center, Houston, TX, Royal Prince Alfred Hospital/Melanoma Institute Australia/University of Sydney, Sydney, Australia, Royal North Shore Hospital, St Leonards, Australia, University of Sydney, Sydney, Australia

Research Funding

Pharmaceutical/Biotech Company

Background: For several cancers, response to neoadjuvant therapy (NAT) correlates with survival. Targeted and immune therapies achieve high response rates and durable survival in many patients with metastatic melanoma. Their role as NAT for stage III disease is not clear, and whether pathological response following NAT correlates with relapse-free (RFS) or overall survival (OS) in melanoma is unknown. Methods: Pooled clinical data from four ongoing NAT clinical trials (NCT02437279, NCT02231775, NCT02519322, NCT01972347) at three large melanoma centers participating in the INMC were examined. All trials included only patients with surgically resectable clinical stage III melanoma. NAT regimens included dabrafenib/trametinib (DT) and nivolumab (nivo) [single agent or in combination with ipilimumab (ipi/nivo)]. Patients who had undergone surgery prior to 27th January 2017 are included in this preliminary analysis. A pathological complete response (pCR) was defined as no viable melanoma cells in the resected specimen by hematoxylin and eosin evaluations by dedicated dermatopathologists. Results: 58 patients with clinical stage III melanoma (AJCCv7: 18 IIIB, 40 IIIC) have completed NAT and undergone surgery. 18 received neoadjuvant immunotherapy (IT): ipi/nivo x2 doses (N = 10), ipi/nivo x3 doses (N = 4) or nivo x4 doses (N = 4). 40 received neoadjuvant DT, either for two (N = 10) or three months (N = 30). Median age is 55 years (range 22-84). A pCR was observed in 50% of patients, 7 (39%) with IT and 22 (55%) with DT. Median follow-up is 10.2 months (95% CI 8.7-12.5). 14 (24%) patients have recurred (5 local, 8 distant, 1 both), 2 (11%) after IT, 12 (30%) after DT. For those with pCR, 14% have recurred, 0/7 (0%) after IT, 4/22 (18%) after DT. In contrast, for those without pCR, 34% have recurred, 2/11 (18%) after IT and 8/18 (44%) after DT. Two deaths have occurred, both after neoadjuvant TT. Early data suggests improved RFS in those with pCR. Conclusions: Neoadjuvant targeted and immunotherapy are active regimens in clinical stage III melanoma patients and are associated with high pCR rate. Preliminary data suggest pCR correlates with improved RFS. Updated data will be presented. Clinical trial information: NCT02437279, NCT02231775, NCT02519322, NCT01972347

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Local-Regional Disease

Clinical Trial Registration Number

NCT02437279, NCT02231775, NCT02519322, NCT01972347

Citation

J Clin Oncol 35, 2017 (suppl; abstr 9581)

DOI

10.1200/JCO.2017.35.15_suppl.9581

Abstract #

9581

Poster Bd #

189

Abstract Disclosures