FRIDAY, March 10, 2023 -- For patients with resectable stage III or IV melanoma, event-free survival is longer for those receiving neoadjuvant and adjuvant pembrolizumab compared with those receiving only adjuvant pembrolizumab, according to a study published in the March 2 issue of the New England Journal of Medicine.

Sapna P. Patel, M.D., from the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues randomly assigned patients with clinically detectable, measurable stage IIIB to IVC melanoma that was amenable to surgical resection to three doses of neoadjuvant pembrolizumab, surgery, and 15 doses of adjuvant pembrolizumab (neoadjuvant-adjuvant group) or to surgery followed by pembrolizumab every three weeks for 18 doses (adjuvant-only group; 154 and 159 patients, respectively).

The researchers found that the neoadjuvant-adjuvant group had significantly longer event-free survival than the adjuvant-only group at a median follow-up of 14.7 months. Event-free survival at two years was 72 and 49 percent in the neoadjuvant-adjuvant group and the adjuvant-only group, respectively, in a landmark analysis. The percentage of patients with treatment-related adverse events of grades 3 or higher was 12 and 14 percent in the neoadjuvant-adjuvant and adjuvant-only groups, respectively.

"These data add to the body of knowledge supporting the use of neoadjuvant therapy in oncology," the authors write.

The study was funded in part by Merck, the manufacturer of pembrolizumab.

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