ASCO 2023 | OpACIN-neo and PRADO: personalized neoadjuvant IO for melanoma based on pathologic response

Irene Reijers, MD / PhD student, Netherlands Cancer Institute, Amsterdam, Netherlands, provides an overview of the Phase II OpACIN-neo (NCT02977052) trial and the PRADO extension cohort, investigating neoadjuvant ipilimumab plus nivolumab in high-risk stage III melanoma. Previously it had been observed that melanoma patients with a pathologic response to adjuvant therapy have better outcomes, while those without a response had a poor prognosis. In the OpACIN-neo trial, adjuvant systemic therapy after therapeutic lymph node dissection (TLND) was excluded, while PRADO adopted a personalized approach. In PRADO, subsequent treatment regimens were personalized based on the pathologic response in the index lymph node. Patients with a major pathologic response (MPR) omit TLND and adjuvant systemic therapy, while patients with pathologic non-response (pNR) receive adjuvant systemic therapy with or without radiotherapy after TLND. The analysis aimed to determine the impact of omitting TLND in MPR patients and adding adjuvant systemic therapy in pNR patients on long-term survival. This interview took place at the American Society of Clinical Oncology (ASCO) 2023 Annual Congress in Chicago, IL.

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