Erschienen in:
01.04.2020 | ASO Author Reflections
ASO Author Reflections: Is There a Re-invigorated Role for Melanoma Metastasectomy in a Checkpoint Blockade Era?
verfasst von:
Danielle M. Bello, MD, Charlotte E. Ariyan, MD, PhD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 4/2020
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Excerpt
Prior to the introduction of checkpoint blockade and targeted therapies, surgical resection of metastatic melanoma in selected patients has been associated with long-term survival. This is most notably supported by data from the MMAIT-IV trial,
1 where patients were randomized to receive either an allogenic melanoma vaccine, Canvaxin plus BCG, or BCG alone, following complete resection of all metastatic disease. While the trial did not demonstrate a survival difference between Canvaxin and BCG, there was a notable 43% 5-year overall survival in both treatment arms following complete surgical resection of up to five sites of metastatic disease. These were some of the best reported survival outcomes for patients with stage IV disease in an era of limited systemic treatment, suggesting that improved survival was achievable in the context of appropriate surgical selection. The question facing clinicians today is whether a metastasectomy should be performed when the disease fails to completely respond to checkpoint inhibitor (CPI) therapy. …