In a nutshell
The aim of this study was to investigate the long-term safety and effectiveness of pembrolizumab (Keytruda) for patients with stage III melanoma that was surgically removed. The study found that patients treated with pembrolizumab were more likely to have an improved outcome.
Some background
Melanoma is one of the most aggressive forms of skin cancer. Treatment for melanoma includes surgery to remove the tumor. In some patients, the tumor can come back after surgery (recurrence). In more advanced melanoma, the tumor can spread to other parts of the body (metastasis).
In patients with more advanced stage melanoma, the risk of recurrence or metastasis is higher. To avoid this, patients can be given additional therapy after surgery. Some cancer cells can have a large amount of a protein called PD-L1. This helps them to avoid the immune system. Pembrolizumab is an immunotherapy that activates the immune system to detect and kill cancer cells.
A short-term study showed that pembrolizumab given after surgery in patients with stage III melanoma improves survival without cancer recurring in patients. However, it is not yet clear how effective pembrolizumab is in the long term.
Methods & findings
This study included 1019 patients with stage III melanoma. All patients had surgery to remove the tumor. 514 patients were then given pembrolizumab. 505 patients were given a placebo. The average follow-up time was 42.3 months.
At 3.5 years, 65.3% of patients in the pembrolizumab group were alive and without metastasis compared to 49.4% in the placebo group. This benefit was seen in both patients with PD-L1 protein present or absent on cancer cells.
59.8% of patients in the group were alive 3.5 years later without cancer recurrence. This was compared to 41.4% of the placebo group.
The bottom line
The study concluded that pembrolizumab after surgery reduced the risk of recurrence and metastasis in patients with stage III melanoma.
The fine print
This study was funded by Merck, the manufacturer of pembrolizumab.
Published By :
The Lancet. Oncology
Date :
Apr 12, 2021
