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Updates in adjuvant and neoadjuvant therapies for resectable cutaneous melanoma

Matthew J Hadfield1, Sonal Muzumdar2, Ryan J Sullivan3

  • 1Department of Medicine, Division of Hematology/Oncology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Journal of the American Academy of Dermatology
|December 26, 2025
PubMed

Insights

Immune checkpoint inhibitors show promise for earlier melanoma treatment. Neoadjuvant therapy before surgery and use in stage II melanoma may improve patient outcomes and reduce recurrence risk.

Area of Science:

  • Oncology
  • Immunology
  • Dermatology

Background:

  • Melanoma treatment has advanced with immune checkpoint inhibitors (ICI) and MAPK targeted therapies.
  • High-risk melanoma patients still face disease recurrence, necessitating improved strategies.
  • Recent research explores neoadjuvant ICI therapy (pre-surgery) versus adjuvant therapy (post-surgery).

Purpose of the Study:

  • To review clinical trials on neoadjuvant ICI therapy for melanoma.
  • To evaluate the efficacy of ICI in earlier stage melanoma (IIb/IIc).
  • To assess strategies for reducing melanoma recurrence risk.

Main Methods:

  • Review of recent randomized clinical trials.
  • Analysis of studies comparing neoadjuvant versus adjuvant ICI treatment.
  • Examination of trials investigating ICI for stage IIb/IIc melanoma.

Main Results:

  • Neoadjuvant ICI therapy (pre-surgery) shows potential benefits.
  • ICI use in earlier stage melanoma (stage II) is under investigation.
  • Emerging evidence suggests improved outcomes with these approaches.

Conclusions:

  • Neoadjuvant immune checkpoint inhibitors may enhance melanoma treatment efficacy.
  • Expanding ICI use to earlier melanoma stages could improve patient prognoses.
  • Further research is warranted to optimize ICI use for melanoma recurrence reduction.
Keywords:
BRAF-targeted therapiesBRAF/MEK combinationT-cell immunoglobulin and immunoreceptor tyrosine inhibitory motif (TIGIT) immune agonistscheckpoint inhibitorsdabrafenibipilimumablymphocyte activation gene 3 (LAD-3)melanomamelanoma adjuvant therapymelanoma neoadjuvant therapymelanoma-associated neoantigensmessenger RNA vaccinesmitogen-activated protein kinase–targeted therapiesnivolumaboncolytic virusesprogrammed cell death protein 1 (PD-1)resectable melanomatrametinibtumor-infiltrating lymphocytestyrosine kinase inhibitors

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