In the past couple of years, research into the use of targeted and immunotherapies BEFORE the removal of melanoma lesions has been evaluated by researchers and are showing promise. Here are prior reports: Neoadjuvant treatments for melanoma
Now, there are these:
Neoadjuvant dabrafenib combined with trametinib for resectable, stage IIIB-C, BRAFV600mutation-positive melanoma (NeoCombi): a single-arm, open-label, single-centre, phase 2 trial. Long, Saw, Lo, et al. Lancet Oncol. 2019 Jun 3.
Between Aug 20, 2014, and April 19, 2017, 40 patients were screened, of whom 35 eligible patients were enrolled, received neoadjuvant dabrafenib plus trametinib, and underwent resection. At the data cutoff (Sept 24, 2018), median follow-up was 27 months (IQR 21-36). At resection, 30 (86%) patients achieved a RECIST response; 16 (46%) had a complete response and 14 (40%; 24-58) had a partial response. Five patients (14%) had stable disease, and no patients progressed. After resection and pathological evaluation, all 35 patients achieved a pathological response, of whom 17 (49%) patients had a complete pathological response and 18 (51%) had a non-complete pathological response. Treatment-related serious adverse events occurred in six (17%) of 35 patients and grade 3-4 adverse events occurred in ten (29%) patients. No treatment-related deaths were reported.
Neoadjuvant dabrafenib plus trametinib therapy could be considered in the management of RECIST-measurable resectable stage III melanoma as it led to a high proportion of patients achieving a complete response according to RECIST and a high proportion of patients achieving a complete pathological response, with no progression during neoadjuvant therapy.
Hang tough ratties. You give us hope! - c