Neoadjuvant therapy in melanoma: Novel treatment strategies and the importance of the pathologic response

The presentation discusses significant advancements in neoadjuvant therapy for melanoma, a treatment approach administered before surgery to reduce tumor size. The speaker explores the evolution of this strategy, emphasizing the role of targeted therapies and immune checkpoint inhibitors that have reshaped standards of care for metastatic melanoma. The International Neoadjuvant Melanoma Consortium (INMC) is highlighted for its efforts to create a unified pathologic assessment framework to evaluate patient responses from various trials, facilitating better interpretation and comparison of outcomes. Key findings indicate that pathologic response is a crucial predictor of patient prognosis and survival rates, with a complete pathologic response correlating strongly with improved outcomes. The discussion includes results from trial comparisons of neoadjuvant and adjuvant therapies, showing significant advantages for neoadjuvant strategies in terms of recurrence-free survival. The presentation also addresses future treatment approaches that aim for de-escalation of therapies to minimize morbidity while ensuring effective cancer management. Overall, the findings position neoadjuvant therapy as the new standard of care for high-risk melanoma patients, accompanied by a call for ongoing collaboration in the oncology community.