Melanoma breakthrough - neoadjuvant treatment saving lives.

Melanoma breakthrough - neoadjuvant treatment saving lives.

9 February 2021

In what is being hailed as one of the biggest breakthroughs in melanoma treatment since the advent of immunotherapy, a new study has revealed that drug treatment before surgery is effective in preventing deadly spread of the disease.


The study, published today in the prestigious journal Nature Medicine, pooled data from six clinical trials where drug therapy was given before surgery, known as neoadjuvant therapy.

Researchers found that giving Stage III patients a short course of pre-operative targeted or immunotherapy was effective, and the stronger a patient’s response to that treatment in the first six to nine weeks, the greater the likelihood their disease would not recur after surgery.

Remarkably, in the 75% of patients who responded well to dual immunotherapy given before surgery, only 3% saw their tumours return after surgery, suggesting that 97% will likely be cured.

‘The neoadjuvant approach is a new way of dealing with melanoma and is a game changer for Stage III patients with bulky disease which has spread to their lymph nodes,’ said Professor Georgina Long AO, Melanoma Institute Australia (MIA) Co-Medical Director and study senior author.

‘We have flipped the ‘surgery then drugs’ rationale on its head. By utilising our arsenal of ground-breaking new treatments before surgical removal of the tumours, this approach is proving effective in stopping melanoma in its tracks and preventing its recurrence and spread to distant organs.’

Data from the study suggests that immunotherapy may work more effectively when given before, rather than after surgery, due to the presence of the bulky tumour provoking an immune response. The concept is similar to sniffer dogs being trained by exposure to illegal drugs – if they know what they’re searching for, the more effective they are at detection.

In addition to training the immune system to work more effectively against melanoma, neoadjuvant therapy also enables a clinician to assess early on if a patient is responding to a particular treatment and decide on an alternative plan if needed. It can also make surgery less complex.

Associate Professor Alex Menzies, MIA Oncologist and study first author, said; ‘Although neoadjuvant therapy for Stage III patients is not currently an approved standard of treatment, we anticipate that this will ultimately change following the very promising clinical trial results.’

The currently approved schedule is to first surgically remove the melanoma tumours, and then give targeted or immunotherapy post-operatively (known as adjuvant therapy). This approach halves the risk of melanoma recurrence. However it’s impossible to tell on an individual level whether the drug treatment is working.

‘This study shows that giving drug therapy before surgery reduces risk of recurrence even further, preventing spread to vital organs like the brain and liver and saving more lives. We can also now tell whether the drugs are working for an individual patient, so we can direct subsequent treatment and follow-up accordingly,’ Associate Professor Menzies said.

Professor Long added: ‘This early marker of a patient’s response to treatment should be considered a new benchmark for rapid drug development in melanoma. It is also a great platform to help fast track laboratory research to understand why some patients do not respond to treatment.’

Melanoma Institute Australia has been instrumental in trialling neoadjuvant drug therapy and is a foundation member of the International Neoadjuvant Melanoma Consortium (INMC).
This study is the first large analysis of immunotherapy in the neoadjuvant setting in any cancer, results of which should pave the way for the use of immunotherapy pre-operatively in many other cancer types.

Australia has the highest melanoma rates in the world with one person diagnosed every 30 minutes, and it is estimated 1300 people will die from the disease in Australia this year.

This latest research has focussed on patients with earlier stage melanoma (Stage III), and how to prevent their disease from progressing to advanced melanoma. The study will also assist with the transition of drug development into the neoadjuvant setting rather than the increasingly complex and inefficient metastatic setting.

‘Treatment for advanced melanoma patients, where their disease has metastasised and spread to distant organs, has come a long way in the last decade,’ said Professor Richard Scolyer, MIA Co-Medical Director.
‘It is exciting that patients with earlier stage disease are now also benefiting from research breakthroughs. If we can prevent these patients from progressing to Stage IV or metastatic disease, then we will be even closer to achieving our goal of zero deaths from melanoma.’


Read the paper in Nature Medicine: 
'Pathological response and survival with neoadjuvant therapy in melanoma: a pooled analysis from the International Neoadjuvant Melanoma Consortium (INMC)’

Alexander M. Menzies, Rodabe N. Amaria, Elisa A. Rozeman, Alexander C. Huang, Michael T. Tetzlaff, Bart A. van de Wiel, Serigne Lo, Ahmad A. Tarhini, Elizabeth M. Burton, Thomas E. Pennington, Robyn P. M. Saw, Xiaowei Xu, Giorgos C. Karakousis, Paolo A. Ascierto, Andrew J. Spillane, Alexander C. J. van Akkooi, Michael A. Davies, Tara C. Mitchell, Hussein A. Tawbi, Richard A. Scolyer, Jennifer A. Wargo, Christian U. Blank & Georgina V. Long. Nat Med (2021). 


For media enquiries, please contact:
Jennifer Durante |Melanoma Institute Australia | 0412 798 990 | jennifer.durante@melanoma.org.au

Melanoma March keeps marching
14 Mar 2018

Melanoma March keeps marching

Weekend two hit the ground marching with Melanoma Marches in Wollongong, Townsville, Mandurah and Western Sydney.

Melanoma March kicks off for 2018
08 Mar 2018

Melanoma March kicks off for 2018

Melanoma Institute Australia's annual fundraising initiative is all systems go!

Calls for urgent crackdown on illegal backyard solariums
07 Mar 2018

Calls for urgent crackdown on illegal backyard solariums

The reported proliferation of illegal commercial solariums is costing lives and requires urgent government intervention.

15-year-old melanoma survivor Toby Rayner will lead Mount Gambier's march against melanoma
28 Feb 2018

15-year-old melanoma survivor Toby Rayner will lead Mount Gambier's march against melanoma

15-year-old melanoma survivor Toby Rayner will lead Mount Gambier’s march against melanoma Julie-Ann Sams knows all too well that melanoma doesn’t discriminate. 

Excision margins for melanoma redefined
21 Feb 2018

Excision margins for melanoma redefined

Updated guidelines defining appropriate excision margins have been published thanks to research from MIA. 

A Pawsome Story of Hope
21 Feb 2018

A Pawsome Story of Hope

Joanne and her trusty companion Frankie spend their days spreading a message of hope in hospitals, nursing homes, even prisons. It is a long way from her darkest hour facing palliative care. This is her story of hope.

A new generation of melanoma researchers
15 Feb 2018

A new generation of melanoma researchers

Melanoma impacts more Australian teenagers and young adults than any other cancer. Dr James Wilmott, who has a young family of his own, has devoted his career to determining why these young Australians are susceptible to melanoma, and importantly, how to save them.

Melanoma Masterclass celebrates Australian luminaries who have transformed melanoma treatment worldwide
13 Feb 2018

Melanoma Masterclass celebrates Australian luminaries who have transformed melanoma treatment worldwide

The extraordinary contribution of Australia’s most distinguished melanoma clinicians and researchers is being celebrated today.

Prestigious award in pathology for Professor Scolyer
09 Feb 2018

Prestigious award in pathology for Professor Scolyer

Congratulations to Professor Richard Scolyer who was awarded the William O. Russell/Joanne Vandenberge Hill Award of Excellence in Pathology.

A Day in the Life Of... Serigne Lo
09 Feb 2018

A Day in the Life Of... Serigne Lo

A Day in the Life Of... Serigne Lo, Research and BioStatistics Manager at Melanoma Institute Australia

Jay inspires others to help end melanoma and so can you
07 Feb 2018

Jay inspires others to help end melanoma and so can you

Jay was your typical Aussie bloke – a truck driver, husband, dad and mate to many. Then he got melanoma. His cancer diagnosis turned his life upside down.

A dilemma no mother-to-be should face
31 Jan 2018

A dilemma no mother-to-be should face

Clair faced an impossible choice – risk delivering her baby early, or delay potentially life-saving melanoma treatment

Join little Madi and Bettina in the fight against melanoma
25 Jan 2018

Join little Madi and Bettina in the fight against melanoma

Little Madi misses her Dad. But she is determined to honour his memory and support life-saving melanoma research.

Toyota and country music fans invited to tip their hat to help tackle Australia's national cancer – melanoma
19 Jan 2018

Toyota and country music fans invited to tip their hat to help tackle Australia's national cancer – melanoma

Melanoma Institute Australia has teamed up with the Toyota Country Music Festival 2018 in Tamworth!

Sun Protection: Facts and Controversies
18 Jan 2018

Sun Protection: Facts and Controversies

MIA's dermatologist shares her knowledge with GPs on debunking myths and controversies on sunscreen.

Shannan Ponton joins our March for a cure
17 Jan 2018

Shannan Ponton joins our March for a cure

Shannan Ponton thought he was invincible – he wasn’t. But his melanoma battle ended up saving more than his own life. 

Surprising finding in rare form of melanoma get patients closer to personalised medicine
11 Jan 2018

Surprising finding in rare form of melanoma get patients closer to personalised medicine

Researchers have demonstrated that immunotherapy is highly effective in treating a rare form of melanoma – a result that is surprising due to the nature of the tumour.  

Using new technology to prevent melanoma
14 Dec 2017

Using new technology to prevent melanoma

Innovation is helping to prevent melanoma developing in the first place.

Research review of 2017
12 Dec 2017

Research review of 2017

Research from MIA is changing the way melanoma is managed worldwide and improving patient survival. Here are a few of our key highlights from this year.

Translational research funding boost
24 Nov 2017

Translational research funding boost

A prestigious Fellowship has been awarded to fund research that will change the way melanoma treatment is assessed in the future.