Fox Chase Cancer Center Researchers Review Guidelines for Therapies Given to Melanoma Patients Before and After Initial Treatment

Jeffrey Farma, MD, FACS, Chair of the Department of Surgery at Fox Chase Cancer Center, and a team of colleagues recently published an updated review of guidelines governing the use of neoadjuvant and adjuvant therapy for patients with melanoma.

“The landscape for treating patients with melanoma has changed very dramatically, even over the last two years. We’re now really considering how to, in some respects, de-escalate care. This means we can perform less aggressive operations, with less risks, because of the immunotherapy that we are giving before surgery,” said Farma.

The guidelines review provides a look at the most current data involving approaches to melanoma care. It covers practice-changing studies, international guidelines, and current recommendations and areas of controversy when treating melanoma patients in the adjuvant and neoadjuvant settings.

The incidence of cutaneous melanoma, the most common form of melanoma, continues to rise in the United States and most of the world. While efforts at early detection have been made, many cases are still being caught later when primary tumors are in an advanced stage or the cancer has spread to other parts of the body. In these cases, it is especially important that patients be evaluated for multimodality therapy, which includes a combination of surgery, systemic therapy, and at times radiotherapy, according to the new review.

“While many surgical oncologists are probably familiar with these approaches, there are some who may not be on the cutting edge and could benefit from this review,” said Farma. “These patients who present with advanced melanoma should be presented in a multidisciplinary tumor board and really be considered for a neoadjuvant approach that a lot of people have not adopted yet.”

Farma wrote the review with colleagues Anthony Olszanski, MD, RPh, Vice Chair of Clinical Research in the Department of Hematology/Oncology at Fox Chase, as well as Jane Messina, MD, and Vernon Sondak, MD, both of the Moffitt Cancer Center in Tampa, Florida.

“The excitement and enthusiasm over advances in the field are changing the paradigm of the disease. However, there are still many unanswered questions and progress that needs to be made. We need better ways to assess treatment response and have more concise recommendations for surveillance,” Farma said.

“The landscape and changes in the treatment of melanoma have been at times unbelievable. We expect to see more impact as new therapies, treatment strategies, and consolidation of care are on the horizon.”

The review, “Annals of Surgical Oncology Practice Guideline Series: Adjuvant and Neoadjuvant Therapy for Melanoma,” was published in Annals of Surgical Oncology, an official journal of The Society of Surgical Oncology.