Adjuvant Therapy for High-Risk Melanoma: An In-Depth Examination of the State of the Field

The consideration of systemic adjuvant therapy is recommended for patients with stage IIB-IV melanoma who have undergone surgical resection due to a heightened risk experiencing relapse and mortality from melanoma. Adjuvant options tested over the past three decades include high-dose interferon-α, immune checkpoint inhibitors (pembrolizumab, nivolumab), targeted (dabrafenib-trametinib BRAF mutant melanoma), radiotherapy chemotherapy. Most these therapies been demonstrated enhance relapse-free survival (RFS) but limited no impact on overall (OS), as reported in randomized trials. In contemporary clinical practice, treatment approach surgically resected III-IV has notable shift towards utilization nivolumab, pembrolizumab, BRAF-MEK inhibitors, such dabrafenib plus trametinib (specifically melanoma) significant enhancements RFS observed treatments. Pembrolizumab obtained regulatory approval United States treat IIB-IIC melanoma, while nivolumab currently under review same indication. This comprehensively analyzes completed phase III trials therapy. Additionally, it provides summary ongoing an overview main challenges future directions