Adjuvant immunotherapy in the modern management of resectable melanoma: current status and outlook to 2028
Marco Donia, Henrik Jespersen, Mathilde Jalving, Rebecca Lee, Hanna Eriksson, Christoph Höeller, Micaela Hernberg, I. Gavrilova, Lidija Kandolf, Gabriella Liszkay, Hildur Helgadóttir, A. Zhukavets, Dace Pjanova, Iván Márquez‐Rodas, Bart Neyns, Hans M. Westgeest, Ivan Pourmir, Paweł Sobczuk, Eva Ellebæk, Teresa Amaral
Abstract
BACKGROUND: Therapeutic advances have reshaped the treatment landscape for patients with resectable melanoma, particularly for those with stage IIB/C and stage III disease. In this article, we discuss the current status and future outlook of adjuvant immunotherapy for melanoma in Europe. RESULTS: Adjuvant immunotherapy offers significant benefits in terms of recurrence-free survival and distant metastasis-free survival. Uncertainties regarding overall survival (OS) benefits, however, remain. Trials such as Keynote-054, which are expected to provide crucial OS information, have delayed their final analyses until 2027. Additionally, real-world studies have raised questions about the correlation between recurrence-free survival/distant metastasis-free survival improvements observed in clinical trials and OS outcomes in routine clinical practice. These uncertainties have led to ongoing debates about the cost-effectiveness of adjuvant therapies, with disparities in reimbursement policies across Europe reflecting these concerns. CONCLUSION: Looking ahead to 2028, adjuvant immunotherapy will remain a key option of comprehensive melanoma care, particularly for patients with stage IIB/C and stage III with micrometastatic disease, where neoadjuvant immunotherapy is not feasible.