<![CDATA[Dr Sznol on the Nuances of Recommending Neoadjuvant Therapy in Metastatic Melanoma]]>

Advertisement Commentary|Videos|May 8, 2026 Dr Sznol on the Nuances of Recommending Neoadjuvant Therapy in Metastatic Melanoma Mario Sznol, MD, discusses current guidance around the use of neoadjuvant therapy in advanced melanoma. Advertisement “In the neoadjuvant setting, it [likely] turns out that the combination of ipilimumab and nivolumab is better than anti–PD-1 [therapy] alone and probably better than targeted therapies [but] based on…not completely randomized trials.”Mario Sznol, MD, professor of clinical medical oncology at the Miller School of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Health System, discussed the use of neoadjuvant therapy in the treatment of patients with metastatic melanoma. Patients who present with active nodal disease, whether identified through imaging such as PET scans or through physical examination, are now considered strong candidates for neoadjuvant therapy prior to surgery, Sznol said. In this setting, emerging evidence suggests that combination immunotherapy with ipilimumab (Yervoy) plus nivolumab (Opdivo) may offer superior outcomes compared with anti–PD-1 monotherapy and potentially even targeted therapy approaches, although not all supporting trials have been fully randomized.Sznol raised the phase 2 SWOG S1801 trial (NCT03698019), a large investigator-led study that compared neoadjuvant immunotherapy followed by surgery with the more traditional strategy of surgery first followed by adjuvant anti–PD-1 therapy. Data from SWOG S1801 demonstrated a significant improvement in event-free survival for patients treated with neoadjuvant therapy. Although overall survival data remain immature, the magnitude of benefit observed has already influenced clinical practice patterns. As a result, neoadjuvant treatment is favored in eligible patients because the differences in outcomes were “quite dramatic,” Sznol stated. Specifically, the preferred regimen at this time is the so-called “flip-dose” combination of ipilimumab and nivolumab administered for 2 cycles before surgery.Importantly, pathologic response after neoadjuvant therapy is emerging as a critical prognostic marker, Sznol added. Patients who achieve a complete or near-complete pathologic response after those initial 2 cycles of treatment may not require additional systemic therapy following surgery. These patients often experience prolonged progression-free survival, raising the possibility of treatment de-escalation for select individuals.Also at play is the evolving role of surgery, Sznol explained. In some cases, surgeons may only remove the involved lymph node rather than performing more extensive dissections. If pathology demonstrates a major response, patients can be reassured that their risk of recurrence is very low and transition them to surveillance with periodic imaging.For patients who do not achieve a major pathologic response, however, questions remain regarding the optimal next step, Sznol said. Additional postoperative therapy, including BRAF/MEK targeted therapy in patients with actionable mutations, may represent a future strategy, although definitive evidence is still lacking.Ongoing research in the post-neoadjuvant setting will be critical, Sznol added. Future clinical trials may focus on risk-adapted strategies for patients with residual disease after surgery. Therapeutic cancer vaccines represent an area of growing interest in this regard. The hope is that vaccines or other novel therapies could further reduce recurrence risk in patients who do not experience a pathologic complete response, though supporting data are not yet available, Sznol concluded. NewsletterStay up to date on the most recent and practice-changing oncology dataSubscribe Now! Advertisement Related ContentAdvertisementDr Gruenbaum on Where Alternative Options to BTK Inhibitors Stand in MCLByLore Gruenbaum, PhDMay 8th 2026Dr Sznol on Optimal Treatment Sequencing in MelanomaByMario Sznol, MDMay 7th 2026Dr Mauro on the Significance of Alternative TKI Formulations in CMLByMichael J. Mauro, MDMay 7th 2026Dr Olawaiye on the FDA Approval of Relacorilant Plus Nab-Paclitaxel in PROCByAlexander B. Olawaiye, MDMay 7th 2026Dr McGregor on the DAD-IO Trial of Sacituzumab Govitecan and EV in Metastatic Urothelial CarcinomaByBradley A. McGregor, MDMay 6th 2026 Latest CMEVideoProactive Adverse Event Management for HER2+ BTC TreatmentsRahul Gosain, MD, MBA; Rohit Gosain, MD; Rachna T. Shroff, MD, MS, FASCOView moreMultimediaCommunity Practice Connections™: Empowering Interventional Radiologists in the Emerging Era of Oncolytic Immunotherapies for MelanomaYana G. Najjar, MD; Douglas B. Johnson, MD, MSCI; Rahul A. Sheth, MD, FSIR View moreVirtual EventWisconsin Association of Hematology and Oncology1 Session is Available!View moreVideoCommunity Oncology Connections™: Beyond Primary End Points – Digging Into Randomized and Real-World Data to Guide Challenging Treatment Decisions in HR+/HER2− Metastatic Breast Cancer | Empire State Hematology & Oncology SocietySeth A. Wander, MD, PhD; Girish Kunapareddy, MDView moreVirtual EventArkansas Association of Cancer Professionals2 Sessions are Available!View moreVideoCommunity Oncology Connections™: Beyond Primary End Points – Digging Into Randomized and Real-World Data to Guide Challenging Treatment Decisions in HR+/HER2− Metastatic Breast Cancer | South Carolina Oncology SocietySeth A. Wander, MD, PhD; Kit Lu, MDView moreVideo19th Annual New York GU Cancers Congress®Maha Hussain, MD, FACP, FASCO; Daniel P. Petrylak, MDView moreIn-Person + Virtual EventGo to PER in ChicagoMay 29-31, 2026View moreVideoCommunity Oncology Connections™: Beyond Primary End Points – Digging Into Randomized and Real-World Data to Guide Challenging Treatment Decisions in HR+/HER2− Metastatic Breast Cancer | Tennessee Oncology Practice SocietySeth A. Wander, MD, PhD; Kamel Abou Hussein, MDView moreVirtual EventKansas Society of Clinical Oncology1 Session is Available!View moreVideoA Case-Guided Discussion on Managing Immune Thrombocytopenic Purpura (ITP)Cindy Neunert, MD, MSCS; Hanny Al-Samkari, MD; Joseph Shatzel, MD, MCRView moreVideoEvolving Treatment Strategies in Pancreatic Cancer: Current Standards, Emerging Targets, and the Role of Molecular TestingEileen M. O’Reilly, MD; E. Gabriela Chiorean, MD, FASCO; Michael J. Pishvaian, MD, PhD; Brian Wolpin, MD, MPHView moreVideoCases and Conversations™: Sorting Through the Expanding Treatment Options for Patients with Relapsed/Refractory Multiple MyelomaC. Ola Landgren, MD, PhD; Mohamad Mohty, MD, PhD; Surbhi Sidana, MDView moreVideoTumor Board: Expert Insights on Managing Classical 𝘌𝘎𝘍𝘙 Mutations, 𝘌𝘎𝘍𝘙 Exon 20 Insertions, and Atypical 𝘌𝘎𝘍𝘙 Mutations in Metastatic NSCLCBalazs Halmos, MD, MS; Enriqueta Felip, MD, PhD; Julia Rotow, MDView moreVideoMedical Crossfire®: Improving Patient Outcomes in Myeloproliferative Neoplasms With Novel Therapeutic ApproachesRami Komrokji, MD; Gabriela Hobbs, MD; John Mascarenhas, MD; Naveen Pemmaraju, MDView moreVideoPER Tumor Board®: Applying Recent Advances to Transform the Treatment Paradigm in SCLC—Expert Perspectives on New Approvals and Emerging StrategiesJonathan W. Goldman, MD; Percy Lee, MD, FASTRO; Erminia Massarelli, MD, PhD, MS; Misty D. Shields, MD, PhDView moreVideoMedical Crossfire®: Precision Medicine in Glioma Treatment — Integration of Molecular Profiling to Inform Targeted TherapiesVinay K. Puduvalli, MD; Manmeet Ahluwalia, MD, MBA; Stephen J. Bagley, MD, MSCE; Angela Waanders, MD, MPH, MSView moreVideoMedical Crossfire®: Harnessing the Power of Modern Therapies in Newly Diagnosed Multiple MyelomaC. Ola Landgren, MD, PhD; Mohamad Mohty, MD, PhD; Surbhi Sidana, MDView moreVideoMedical Crossfire®: Expert Perspectives on Targeting c-Met Overexpression and 𝘔𝘌𝘛 Genomic Alterations in NSCLC – Unveiling the Complexities of 𝘔𝘌𝘛 DysregulationRebecca Heist, MD, MPH; Alex A. Adjei, MD, PhD, FACP; Sandip Patel, MD, FASCO; Jeremy Segal, MD, PhDView moreVideoCases & Conversations™: Transforming AML Care—Precision Strategies, Evolving Therapies, and Clinical InsightsGail J. Roboz, MD; Hagop Kantarjian, MD; Catherine Lai, MD, MPH; Amer Zeidan, MBBS, MHSView moreVideoMedical Crossfire®: Integrating Next-Generation Endocrine Targeting Therapies to Improve Outcomes for Patients With HR+/HER2- Breast CancerWilliam J. Gradishar, MD, FASCO, FACP; Laura Huppert, MD; Yuan Yuan, MD, PhDView moreVideoGI Tumor Board—Applying Recent Advances in Biomarker Testing and Treatment in Metastatic Colorectal CancerJohn H. Strickler, MD; Stacey A. Cohen, MD; Aparna Parikh, MD; Kanwal P.S. Raghav, MBBS, MDView moreVideoBreast Cancer Tumor Board: Targeting TROP2 – Innovations in Triple-Negative Breast Cancer TreatmentJoyce O’Shaughnessy, MD; Matthew P. Goetz, MD; Hope S. Rugo, MD, FASCOView moreMultimediaEstablishing the Rationale for ADC and ICI Combinations in TNBCVirginia Kaklamani, MD, DSc; Tiffany A. Traina, MD, FASCOView moreMultimediaBreaking Down the Rationale for Targeting TROP2 in TNBCFilipa Lynce, MD; Rita Nanda, MDView moreMultimediaDissecting Clinical Trial and Real-World Data for ADCs in TNBCFilipa Lynce, MD; Rita Nanda, MDView moreMultimediaEvaluating the Latest Data and Ongoing Trials for Novel ADC Approaches in TNBCAditya Bardia, MD, MPH, FASCO; Erika P. Hamilton, MDView moreAudioBreaking Down the Latest Clinical Data for First-line Maintenance and R/R SCLCRahul Gosain, MD, MBA; Rohit Gosain, MD; Hossein Borghaei, DO, MSView moreVideoOptimizing Treatment for Biliary Tract CancersGhassan Abou-Alfa, MD, MBA; Laura Williams Goff, MD, MSCI, MMHC, FASCO; Arndt Vogel, MD, PhDView moreVideoCross-Disease Integration of Immunotherapy InnovationsGhassan Abou-Alfa, MD, MBA; Laura Williams Goff, MD, MSCI, MMHC, FASCO; Arndt Vogel, MD, PhDView moreAudioPractical Considerations and Future Directions for New Treatment Strategies in SCLCRahul Gosain, MD, MBA; Rohit Gosain, MD; Misty D. Shields, MD, PhDView moreMultimediaExpert Guidance on Frequently Asked Questions Regarding the Use of ADCs in TNBCAditya Bardia, MD, MPH, FASCO; Erika P. Hamilton, MD; Virginia Kaklamani, MD, DScView moreVideoBroadening the Frontline—Studies Informing the Use of Immunotherapy in Hepatocellular CarcinomaGhassan Abou-Alfa, MD, MBA; Laura Williams Goff, MD, MSCI, MMHC, FASCO; Arndt Vogel, MD, PhDView moreMultimediaPER Resource Center: Integrating Novel Approaches in TNBC – New Avenues for TROP2-Targeting ADCs and Beyond – NursingAditya Bardia, MD, MPH, FASCO; Erika P. Hamilton, MD; Virginia Kaklamani, MD, DSc; Filipa Lynce, MD; Rita Nanda, MD; Tiffany A. Traina, MD, FASCOView moreMultimediaExpert Roundtable and Panel Discussions: Current and Future Landscape of TNBCAditya Bardia, MD, MPH, FASCO; Erika P. Hamilton, MD; Tiffany A. Traina, MD, FASCOView moreVideoShow Me the Data®: New and Emerging Roles for Oral SERD Therapy in the Treatment of ER+/HER2– Breast CancerAna C. Garrido-Castro, MD; Pedram Razavi, MD, PhDView moreAudioNavigating Treatment Gaps in SCLC: Relapse, Resistance, and Need for New OptionsRahul Gosain, MD, MBA; Rohit Gosain, MD; Giannis Mountzios ΜD, PhDView moreVideoMedical Crossfire® in Adjunctive Testing: Charting a New Course in Prostate Cancer Risk AssessmentJason Hafron, MD; Aaron D. Berger, MD; Arpeet Shah, MDView moreMultimediaReady for Radioligand Therapy? Patient Selection and Sequencing SimplifiedJeremie Calais, MD, PhD; Tanya B. Dorff, MD; Scott T. Tagawa, MD, MS, FACP, FASCOView moreMultimediaWorking Together: Overcoming Barriers to Optimize Outcomes in Patients Treated With Radioligand Therapy Through Multidisciplinary CareJeremie Calais, MD, PhD; Tanya B. Dorff, MD; Nerina McDonald, MSPAS, PA-C; Scott T. Tagawa, MD, MS, FACP, FASCOView moreMultimediaBURST CME™ Resource Center: Integrating Novel PSMA-Directed Radioligand Approaches for Diagnosis and Management of Prostate CancerJeremie Calais, MD, PhD; Tanya B. Dorff, MD; Nerina McDonald, MSPAS, PA-C; Scott T. Tagawa, MD, MS, FACP, FASCOView moreMultimediaImaging Matters: Decoding PSMA PET for Better Decision-MakingJeremie Calais, MD, PhD; Tanya B. Dorff, MD; Scott T. Tagawa, MD, MS, FACP, FASCOView moreMultimediaRadioligand Therapy 101: The Science Behind the StrategyJeremie Calais, MD, PhD; Tanya B. Dorff, MD; Scott T. Tagawa, MD, MS, FACP, FASCOView moreVideo Advances in Managing EGFR-Mutant NSCLC: Applying Evidence Across the Disease ContinuumTina Cascone, MD, PhD; Christina Baik, MD, MPH; David Planchard, MD, PhDView moreMultimediaCommunity Practice Connections™: Enhancing Melanoma Outcomes With Intratumoral Oncolytic Immunotherapy–Strategies for the Multidisciplinary TeamYana G. Najjar, MD; Sapna Patel, MDView moreVideoA New Era of Targeted Therapy for Advanced NSCLC: Exploring Future Directions for Bispecific Antibodies and ADCsSandip Patel, MD, FASCO; Myung-Ju Ahn, MD; Giannis Mountzios, MD, MSc, PhD; Zofia Piotrowska, MD, MHSView moreVideoNavigating Advances in Neovascular Retinal Disease: Translating Evidence to Practice in AMD, DME, and RVOSriniVas R. Sadda, MD, FARVO; Mark R. Barakat, MD, FASRS; David A. Eichenbaum, MD, FASRSView moreVideoEnhancing Prostate Cancer Outcomes – The Role of PSMA and Targeted Treatment StrategiesAna Kiess, MD, PhD; Erin Grady, MD, CCD, FACNM, FSNMMI; Himanshu Nagar, MD, MS; Scott T. Tagawa, MD, MS, FASCO, FACPView moreVideo(CME Track) Antibody–Drug Conjugates in Oncology: The Essentials of AE Management for Better Patient OutcomesMichelle L. Taylor, ANP-BC; Emely Alfaro, DNP, RN, CNS, OCN; Paige Griffith, CRNP; Beth Sandy, MSN, CRNP, FAPOView more Advertisement Advertisement Trending on OncLive1Daraxonrasib Monotherapy Elicits Meaningful Responses in Previously Treated, RAS-Mutated Pancreatic Cancer2FDA Approves Zenocutuzumab for NRG1 Fusion+ Cholangiocarcinoma 3Mentorship Is Key to Advance the Next Generation of Oncology Researchers4Dr Mauro on the Significance of Alternative TKI Formulations in CML5First-Line Danvatirsen Plus Pembrolizumab Fails to Improve Response Rates in Metastatic HNSCC