Neoadjuvant immunotherapy for resectable cutaneous melanoma: a nationwide population-based cohort

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ID: 320466
2026
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Abstract
Abstract Randomized trials have shown that neoadjuvant immune checkpoint inhibitor (ICI) therapy improves outcomes compared with adjuvant therapy in patients with resectable stage III–IV melanoma. However, the generalizability of these findings to routine clinical practice is unclear. We conducted a nationwide, population-based cohort study including 279 consecutive patients with resectable stage III–IV cutaneous melanoma treated with neoadjuvant ICI in Sweden. Outcomes included pathological response, survival and adverse events. Among patients, 94% received PD-1 inhibitor monotherapy and 92% underwent surgery as planned. Major pathological response occurred in 43%, including 37% with complete response. After a median follow-up of 20 months, estimated 24-month EFS was 69%, DMFS 75%, and OS 87%. Pathological response was strongly associated with outcomes. Among 119 patients achieving major pathological response (MPR), withholding adjuvant therapy was associated with recurrence. Outcomes after neoadjuvant ICI were comparable to randomized trials. Withholding of adjuvant therapy after MPR warrants further study.
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openalex_W7167920597 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Axel Nelson, Ellen Krabbe, Karl Björkström, Anne Huibers, Christian U Blank, Braslav Jovanovic, Måns Kadefors, Ana Carneiro, Karolin Isaksson, Sara Wirén, Mikael Wallander, Antonios Valachis, Gustav Ullenhag, H Helgadottir, Lars Ny, Roger Olofsson Bagge
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Journal JNCI Journal of the National Cancer Institute
Year 2026
DOI
10.1093/jnci/djag230
URL
https://doi.org/10.1093/jnci/djag230
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