Study shows immunotherapy may lower recurrence of advanced melanoma
Mays Cancer Center Annual Report
The innovation of Mays Cancer Center researchers is yielding significant inroads for the treatment of all cancers through unique research opportunities and expansion of clinical trial capacity.
“The results are significant for patients who are diagnosed with highrisk melanoma and changes the standard of care. It demonstrates pembrolizumab is best administered before and after surgery.”
– Monte Shaheen, MD, professor of oncology, Division of Hematology and Oncology, and director of the immunotherapy program at Mays Cancer Center
Monte Shaheen, MD, a melanoma expert at Mays Cancer Center at The University of Texas Health Science Center San Antonio, was part of a team of investigators that conducted a phase 2 clinical trial funded by the National Cancer Institute to determine the efficacy and safety of administering the immunotherapy drug pembrolizumab before and after surgery in high-risk melanoma patients.
The results of the clinical trial, published in The New England Journal of Medicine, show that participants with stage 3 or stage 4 melanoma who were given pembrolizumab before and after surgery (neoadjuvant-adjuvant therapy) had significantly lower risks of recurring cancer than participants who received the drug after surgery only (adjuvant-only).
Neoadjuvant therapies are delivered before the main treatment to help reduce the size of a tumor or eradicate cancer cells that have spread. Adjuvant therapies are delivered after the primary treatment to destroy the remaining cancer cells. For this study, patients showed favorable outcomes for the neoadjuvant-adjuvant pembrolizumab in advanced melanoma.
The clinical trial was conducted at several NCIdesignated Cancer Centers across the nation. Shaheen, a professor of oncology at the health science center and director of the immunotherapy program at Mays Cancer Center, was one of the principal investigators of the clinical trial.
Investigators enrolled 345 participants with stage 3 or stage 4 melanoma. Participants aged 18 to 90 randomly received either 200 milligrams of pembrolizumab every three weeks following surgery (adjuvant-only) for a total of 18 doses, or 200 mg of pembrolizumab every three weeks for three doses leading up to surgery (neoadjuvant-adjuvant), then an additional 15 doses following surgery.
Among the participants with stage 3 or stage 4 melanoma, event-free survival was significantly longer for those who started with the neoadjuvant-adjuvant therapy, and no new toxic effects were identified. Event-free survival is defined as the time after treatment when a group of clinical trial participants did not have recurring cancer or conditions.
“The results are significant for patients who are diagnosed with high-risk melanoma and changes the standard of care. It demonstrates pembrolizumab is best administered before and after surgery,” Shaheen said.
“At Mays Cancer Center, our multidisciplinary team provides high-quality comprehensive care for our patients with melanoma. We continue to work to bring novel immunotherapy options to the San Antonio community and South Texas.”
