Related Experiment Video
Updated: Aug 8, 2025

A Melanoma Patient-Derived Xenograft Model
Published on: May 20, 2019
Neoadjuvant-Adjuvant or Adjuvant-Only Pembrolizumab in Advanced Melanoma
Sapna P Patel1, Megan Othus1, Yuanbin Chen1
1From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.).
Adding pembrolizumab before and after surgery significantly improved event-free survival for patients with resectable melanoma. This neoadjuvant-adjuvant therapy demonstrated superior outcomes compared to adjuvant therapy alone, with no new safety concerns identified.
Area of Science:
- Oncology
- Immunotherapy
- Melanoma Research
Background:
- Melanoma is a significant health concern, particularly in stages III and IV.
- Surgical resection is a primary treatment modality for resectable melanoma.
- The role of neoadjuvant and adjuvant immunotherapy in improving outcomes for resectable melanoma requires further investigation.
Purpose of the Study:
- To evaluate the efficacy of neoadjuvant and adjuvant pembrolizumab compared to adjuvant pembrolizumab alone in patients with resectable stage III or IV melanoma.
- To assess the impact of combined neoadjuvant-adjuvant pembrolizumab on event-free survival.
- To determine the safety profile of the neoadjuvant-adjuvant pembrolizumab regimen.
Main Methods:
- A phase 2 randomized trial was conducted with patients having resectable stage IIIB to IVC melanoma.
- Participants were assigned to either neoadjuvant-adjuvant pembrolizumab (pre-surgery and post-surgery) or adjuvant pembrolizumab alone (post-surgery).
- The primary endpoint was event-free survival, with comprehensive safety evaluations performed.
Main Results:
- The neoadjuvant-adjuvant pembrolizumab group showed significantly longer event-free survival compared to the adjuvant-only group (P=0.004).
- Two-year event-free survival was 72% in the neoadjuvant-adjuvant group versus 49% in the adjuvant-only group.
- The incidence of grade 3 or higher treatment-related adverse events was comparable between the two groups (12% vs. 14%).
Conclusions:
- Pembrolizumab administered both before and after surgery significantly enhances event-free survival in patients with resectable stage III or IV melanoma.
- The neoadjuvant-adjuvant approach offers a promising strategy for improving treatment outcomes in this patient population.
- No novel toxicities were observed, supporting the safety of this combined treatment regimen.
Related Concept Videos
Tumor Immunotherapy
Treatment Resistant Cancers
Targeted Cancer Therapies
There are several types of targeted therapies against...
Adaptive Mechanisms in Cancer Cells
Some of the advantages that cancer cells have on normal cells include - enhanced ability to divide without terminally differentiating, induce new blood vessel formation,...

