{"entity":{"id":"swog-s1801","kind":"trial","name":"SWOG S1801","aka":[],"tldr":"Simply moving three doses of the same drug to before surgery improved outcomes, a result that changed how the field thinks about timing.","summary":"2-year EFS 72% vs 49% (HR 0.58), NEJM 2023. Same total drug exposure in both arms; the difference is attributed to priming the immune response while the tumour and its draining nodes are still present. Three-year follow-up presented at ESMO 2025 sustained the benefit. Together with NADINA it established neoadjuvant immunotherapy as standard for resectable stage III disease.","status":"positive","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT03698019","url":"https://clinicaltrials.gov/study/NCT03698019"},{"label":"NEJM 2023","url":"https://www.nejm.org/doi/full/10.1056/NEJMoa2211437"}],"tags":[],"related":[],"cancers":["melanoma","stage-iii-melanoma"],"sections":[],"technologies":["checkpoint-inhibitor"],"targets":["pd1"],"drugs":["pembrolizumab"],"companies":["swog"],"institutions":[],"pathways":[],"terms":["neoadjuvant-adjuvant"],"trials":[],"people":["sapna-patel"],"bottlenecks":[],"keyPapers":["paper-swog-s1801-n-engl-j-med-2023"],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT03698019","phase":"2","setting":"Resectable stage IIIB-IV melanoma: three doses of pembrolizumab before surgery then 15 after, vs 18 doses after surgery","sponsor":"SWOG / NCI","result":"2-year EFS 72% vs 49%; HR 0.58.","started":"2019-02-15","startedType":"actual","yearReported":2022,"enrolled":313,"enrolledBasis":"registry","outcomes":[{"endpoint":"Event-free survival at 2 years","primary":true,"unit":"%","arms":[{"name":"Neoadjuvant + adjuvant pembrolizumab","value":72},{"name":"Adjuvant pembrolizumab","value":49}],"hr":0.58,"source":"https://www.nejm.org/doi/full/10.1056/NEJMoa2211437"}],"replication":"Replicated in principle by NADINA with a different regimen."},"route":"/trials/swog-s1801/","neighbours":{"cancer":[{"id":"melanoma","kind":"cancer","name":"Melanoma","route":"/cancers/melanoma/"},{"id":"stage-iii-melanoma","kind":"cancer","name":"Stage III melanoma (after surgery)","route":"/cancers/stage-iii-melanoma/"}],"technology":[{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"}],"target":[{"id":"pd1","kind":"target","name":"PD-1","route":"/targets/pd1/"}],"drug":[{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}],"company":[{"id":"swog","kind":"company","name":"SWOG Cancer Research Network","route":"/companies/swog/"}],"term":[{"id":"neoadjuvant-adjuvant","kind":"term","name":"Neoadjuvant / adjuvant / perioperative","route":"/terms/neoadjuvant-adjuvant/"}],"person":[{"id":"sapna-patel","kind":"person","name":"Sapna P. Patel","route":"/people/sapna-patel/"}],"paper":[{"id":"paper-swog-s1801-n-engl-j-med-2023","kind":"paper","name":"Neoadjuvant-Adjuvant or Adjuvant-Only Pembrolizumab in Advanced Melanoma","route":"/key-papers/paper-swog-s1801-n-engl-j-med-2023/"}],"pairing":[{"id":"neoadjuvant-io-response-adapted","kind":"pairing","name":"Neoadjuvant immunotherapy → response-adapted adjuvant","route":"/pairings/neoadjuvant-io-response-adapted/"}],"roadmap":[{"id":"surgery-roadmap","kind":"roadmap","name":"Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work","route":"/roadmaps/surgery-roadmap/"}]}}