Expert discusses uncertainties in melanoma adjuvant therapy sequencing

Dr. Mario Sznol, a professor of clinical medical oncology at the University of Miami, highlighted the difficulty of deciding whether to give adjuvant treatment to melanoma patients given the current evidence.

He explained that while BRAF/MEK inhibitor combos show clear benefit for the small group of patients with BRAF-mutant tumors, and KIT inhibitors can help those with KIT mutations, these molecular subsets represent only a minority of melanoma cases.

In contrast, immune checkpoint inhibitors have consistently produced durable responses and remain the mainstay of therapy, but there is still no proof that improving progression-free survival in the adjuvant setting translates into longer overall survival.

As a result, conversations with patients about starting treatment early versus waiting for disease progression remain complex and highly individualized.