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Drug therapy

Moving on up — from stage IV into stage III

Nature Reviews Clinical Oncology volume 14, page 647 (2017)Cite this article

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Effective and well-tolerated adjuvant therapies are a major unmet need for patients with various high-risk stage III cancers. Three practice-changing studies reported for the first time at the ESMO 2017 Congress, and published simultaneously in the New England Journal of Medicine, focused on moving therapies that are effective for unresectable metastatic disease into the 'adjuvant' setting, after curative-intent treatment.

Only ∼40% of patients with resectable stage III–IV melanoma are cured by surgery alone; the cure rate might be increased with adjuvant therapy. In 2015, adjuvant immunotherapy with the anti-CTLA-4 antibody ipilimumab was approved by the FDA based on improved relapse-free survival (RFS) outcomes compared with placebo; however, observation remains the standard of care after resection of melanoma at many centres, owing to the high risk of adverse events associated with ipilimumab. Nivolumab, an anti-PD-1 antibody, has a favourable safety profile and good efficacy in patients with unresectable metastatic melanoma, supporting testing of this agent in the adjuvant setting.

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References

  1. Weber, J. et al. Adjuvant nivolumab versus ipilimumab in resected stage III or IV melanoma. N. Engl. J. Med. http://dx.doi.org/10.1056/NEJMoa1709030 (2017)

  2. Long, G. V. et al. Adjuvant dabrafenib plus trametinib in stage III BRAF-mutated melanoma. N. Engl. J. Med. http://dx.doi.org/10.1056/NEJMoa1708539 (2017)

  3. Antonia, S. J. et al. Durvalumab after chemoradiotherapy in stage III non-small-cell lung cancer. N. Engl. J. Med. http://dx.doi.org/10.1056/NEJMoa1709937 (2017)

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  1. David Killock
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Killock, D. Moving on up — from stage IV into stage III. Nat Rev Clin Oncol 14, 647 (2017). https://doi.org/10.1038/nrclinonc.2017.159

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  • DOI: https://doi.org/10.1038/nrclinonc.2017.159

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