Reijers, Irene L. M. and Menzies, Alexander M. and Lopez-Yurda, Marta and Versluis, Judith M. and Rozeman, Elisa A. and Saw, Robyn P. M. and Houdt, Winan J. van and Kapiteijn, Ellen and Veldt, Astrid A. M. van der and Suijkerbuijk, Karijn P. M. and Eriksson, Hanna and Hospers, Geke A. P. and Klop, Willem M. C. and Acosta, Alejandro Torres and Grijpink-Ongering, Lindsay and Gonzalez, Maria and van der Wal, Anja and Al-Mamgani, Abrahim and Spillane, Andrew J. and Scolyer, Richard A. and Wiel, Bart A. van de and Akkooi, Alexander C. J. van and V. Long, Georgina and Blank, Christian U. (2025) Impact of personalized response-directed surgery and adjuvant therapy on survival after neoadjuvant immunotherapy in stage III melanoma: Comparison of 3-year data from PRADO and OpACIN-neo. EUROPEAN JOURNAL OF CANCER, 214: 115141. ISSN 0959-8049, 1879-0852
Full text not available from this repository. (Request a copy)Abstract
Background: Pathologic response following neoadjuvant immune checkpoint blockade (ICB) in stage III melanoma serves as a surrogate marker for long-term outcomes. This may support more personalized, responsedirected treatment strategies. Methods: The OpACIN-neo and PRADO trials were phase 2 studies evaluating neoadjuvant treatment with ipilimumab and nivolumab in stage III melanoma. In OpACIN-neo, all patients underwent therapeutic lymph node dissection (TLND) without subsequent adjuvant therapy. In contrast, PRADO explored a response- directed strategy, where patients achieving a major pathologic response (MPR) omitted TLND and adjuvant therapy, while those without a pathologic response (pNR) received TLND and adjuvant therapy. Here, we provide a descriptive post-hoc comparison of 3-year survival outcomes between the non-personalized approach in OpACINneo and the response-directed approach in PRADO. Results: For patients who achieved an MPR, the 3-year recurrence-free survival (RFS) was 93 % for those without TLND versus 96 % for those with TLND (log-rank p = 0.47), and distant metastasis-free survival (DMFS) was 98 % compared to 96 % (log-rank p = 0.49), respectively. For patients with pNR, 3-year RFS rates were 64 % for those receiving adjuvant systemic therapy and 35 % for patients without (log-rank p = 0.10). DMFS rates were Conclusions: These data suggest that TLND and adjuvant therapy may be safely omitted in most patients achieving an MPR, while adjuvant systemic therapy following TLND appears to improve RFS and DMFS in patients with pNR. Although these results are hypothesis-generating and require further validation, they offer a potential foundation for developing personalized neoadjuvant immunotherapy approaches.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | NIVOLUMAB; Neoadjuvant therapy; Adjuvant therapy; Immune checkpoint blockade; Immunotherapy; Personalized therapy; Melanoma |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Apr 2026 11:31 |
| Last Modified: | 07 Apr 2026 11:31 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65601 |
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