[Adjuvant treatment for melanoma].

Abstract

Background: Despite adequate treatment the probability of recurrence of malignant melanoma is high in patients with corresponding risk factors. Adjuvant treatment significantly reduces this risk; however, the choice of the appropriate adjuvant treatment can be difficult.

Objectives: This article presents the currently available adjuvant therapies (immune checkpoint inhibition with PD‑1 inhibitors and targeted therapy with BRAF and MEK inhibitors) and a comparison of the effectiveness of treatment in stage III.

Material and methods: A literature search, a discussion of relevant approval studies and discussion of register data were carried out.

Results: Although the available adjuvant therapies significantly reduce the risk of recurrence of malignant melanoma, approximately one quarter of the patients still experience recurrence within the first 2 years. Comparisons of clinical register data show that adjuvant targeted therapy for BRAF-mutated stage III melanoma is superior to PD‑1 inhibition. The final analysis of the COMBI-AD study, the approval trial of dabrafenib and trametinib, shows a survival benefit for melanomas with BRAF^V600E mutations but not for BRAF^V600K mutations compared to placebo .

Conclusion: New therapeutic approaches are urgently needed to further reduce the risk of recurrence of melanoma in the adjuvant setting. Therefore, suitable patients should be included in appropriate adjuvant clinical studies, if these are available at the respective sites.