Neoadjuvant immunotherapy has once again proven its power in patients with stage 3 melanoma, according to in Nature published results of the PRADO study.
The OpACIN neo study, the precursor to PRADO, had already shown that a combination of ipilimumab and nivolumab prior to lymph node surgery produced a high response rate of 77%, with acceptable side effects.
PRADO was primarily an extension of OpACIN-neo with 99 new patients. The researchers also decided to investigate whether follow-up treatment could be adjusted based on a patient’s response.
In patients with a very good response, extensive lymph node surgery was omitted, patients with a partial response were operated on, and patients with a poor response received surgery as well as follow-up treatment with immunotherapy or targeted therapy and possibly radiotherapy.
The results of the OpACIN neo study could be largely confirmed with PRADO. The response rate was almost as high (72%) and the side effects of the immunotherapy were acceptable. In addition, 61% of the patients had a very good response, without extensive lymph node surgery. This resulted in fewer side effects of the surgery and a better quality of life.