Marco Donia: Adjuvant Immunotherapy for Melanoma and What’s Next in Europe
Marco Donia, Associate Professor in Clinical Oncology at the University of Copenhagen, shared a post on LinkedIn:
“Adjuvant Immunotherapy for Melanoma and What’s Next in Europe.
In an era of rapid progress in neoadjuvant immunotherapy for macroscopic resectable melanoma, with Teresa Amaral, Eva Ellebæk and an outstanding group of new and established European melanoma clinicians, we discussed the current and future role of adjuvant immunotherapy in stage ≥IIB melanoma.
Key Points:
- Adjuvant Therapy in 2025: A considerable proportion of patients with resectable stage ≥IIB melanoma remain candidates for adjuvant therapy (when neoadjuvant is not feasible or not reimbursed).
- Recurrence-Free Survival (RFS) & Distant Metastasis-Free Survival (DMFS): Adjuvant immunotherapy significantly improves both, reducing the risk of recurrence.
- Overall Survival (OS) Uncertainty: While RFS and DMFS benefits are clear, the impact on OS remains under investigation, underscoring the need for patient-centered discussions on risks vs. benefits.
- Heterogeneous Access Across Europe: Reimbursement policies vary widely, affecting availability and patient access to adjuvant therapy.
- The Road Ahead: Individualized treatment approaches, biomarker-driven decisions, and new combination strategies will be key for patients who are not candidates for neoadjuvant therapy.
Take-Home Message:
- Adjuvant immunotherapy remains a key treatment option today and will continue to be relevant in the coming years.
- Shared decision-making is critical, factoring in clinical data, patient preferences, and country-specific reimbursement.
Clinical Implications:
- Identifying who benefits most from adjuvant therapy remains a top priority.
- Long-term data will be crucial in balancing efficacy and safety.
Results Awaited:
We eagerly await OS results from Keynote-054 and the primary results of Interpath-001 (mRNA vaccine + anti-PD-1), especially after the LAG-3/PD-1 adjuvant combination failed to improve outcomes over PD-1 monotherapy.
A pleasure to collaborate with an exceptional group of colleagues on this important discussion!
Looking forward to future insights and debates.”
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