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A Single Dose of a PD-1 Inhibitor Before Surgery May Predict Outcomes in Patients With Melanoma

A single dose of a programmed cell death protein 1 (PD-1) inhibitor before resection for melanoma may predict clinical outcomes for patients. Researchers from the Abramson Cancer Center at the University of Pennsylvania—who documented this finding in the largest cohort of patients to be treated with anti–PD-1 drugs before surgery—also showed that immune responses brought on by this therapy can peak as early as 7 days after treatment—much earlier than previous studies have shown. These findings were published by Huang et al in Nature Medicine.

Patients in this study completed up to a year of anti–PD-1 therapy after surgery, and those with complete responses after the initial dose have remained cancer-free for more than 2 years. Further, researchers also identified patterns in the way melanoma that recurs after resection adapts to develop resistance to PD-1 inhibitors, potentially paving the way for greater understanding of how best to help these patients.

“Knowing so much earlier whether or not patients are responding to PD-1 inhibitors may give us the ability to guide them to the most appropriate therapy with the greatest chance for success,” said the study’s lead author Alexander C. Huang, MD, an instructor of Hematology-Oncology in Penn’s Perelman School of Medicine and a Parker Bridge Scholar through the Parker Institute for Cancer Immunotherapy.

Currently, the standard of care in resectable melanoma includes surgery followed by a year of drug treatment in select high-risk patients, which can include immunotherapy like anti­–PD-1 treatment.

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