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Updated: Mar 23, 2026
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A Robust Discovery Platform for the Identification of Novel Mediators of Melanoma Metastasis
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Salvage Metastasectomy After Adoptive Cell Transfer for Melanoma: Long-Term Updates
Aaron J Dinerman1, Alexandra M Gustafson1, Kyle J Hitscherich1
1Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Annals of Surgical Oncology
|March 22, 2026
Summary
Metastatic melanoma patients responding to adoptive cell transfer (ACT) who experience limited progression may benefit from salvage surgery. This approach offers durable disease control for some, highlighting a potential salvage option for localized failures after ACT.
Area of Science:
- Oncology
- Immunotherapy
- Surgical Oncology
Background:
- Adoptive cell transfer (ACT) offers durable regression for metastatic melanoma.
- Some patients initially responding to ACT may experience disease progression, necessitating salvage therapies.
Purpose of the Study:
- To evaluate the efficacy of surgical management for extracranial oligoprogression after initial response to ACT in metastatic melanoma patients.
- To identify potential genomic mechanisms of tumor escape following ACT.
Main Methods:
- Retrospective review of metastatic melanoma patients treated with ACT (2000-2022).
- Identification of patients with objective response or stable disease (SD6) who developed oligoprogression managed with metastasectomy.
- Analysis of progression-free survival (PFS) and overall survival (OS) post-surgery.
- Exploratory genomic analysis of tumor escape mechanisms.
Main Results:
- 30 of 138 (21%) patients with initial response/SD6 underwent metastasectomy for extracranial oligoprogression.
- Median OS was not reached; median PFS was 10.5 months.
- Ten-year OS was 54.7%, plateauing after 6 years.
- Genomic analysis revealed mutational evolution and loss of neoantigens in some patients.
Conclusions:
- Surgical management of oligoprogression after ACT provides durable disease control in 27% of selected patients.
- Metastasectomy represents a potentially viable salvage option for localized failures post-ACT.
- Further research is needed to define patient selection criteria for salvage metastasectomy.
