Pathological assessment of neoadjuvant-treated melanoma specimens: a historical overview, lessons learned along the way and the road ahead.

Abstract

Neoadjuvant therapy has been recently established as the standard of care in surgically resectable stage III melanoma. Insofar as the extent of tumour response correlates with metrics of patient survival, this underscores the critical ongoing need for rigorous and reproducible approaches to pathological response assessment following surgery. In the current review, we provide a historical overview of early trials assessing safety and efficacy of neoadjuvant targeted and immune therapy, and we summarize the earliest and revised recommendations for pathological response assessment of treated melanoma specimens. Moreover, we highlight that not only the extent of response but also the composition of that response correlates with recurrence-free survival in these high-risk patients.