Loading
Stage IIB and IIC melanomas are thick or ulcerated skin melanomas that have not reached the lymph nodes but still carry a real risk of coming back. A year of pembrolizumab or nivolumab after surgery lowers that risk, though most people in this group would have been cured by surgery alone, so the decision weighs a modest benefit against a year of treatment.
Stage II melanoma is node-negative disease staged by Breslow thickness and ulceration: IIB is a 2 to 4 millimetre ulcerated or a thicker non-ulcerated primary, IIC a primary over 4 millimetres with ulceration. Sentinel node biopsy defines the stage; if it is negative, treatment was for decades surgery alone with surveillance, since adjuvant interferon added little. Yet relapse and death rates for IIB and IIC exceed those of IIIA, and because stage II is so much commoner than stage III it contributes more melanoma deaths in absolute numbers.
KEYNOTE-716 (2021) randomised 976 patients with resected IIB or IIC disease to a year of pembrolizumab or placebo and improved twelve-month recurrence-free survival from 83.1 to 90.5 percent (hazard ratio 0.65), with distant metastasis-free survival also improved and the benefit sustained at five years; pembrolizumab was approved for this stage in December 2021. CheckMate 76K (2023) found the same with nivolumab (twelve-month recurrence-free survival 89.0 against 79.4 percent, hazard ratio 0.42), approved in October 2023. INTerpath-001 (2026), which included stage IIB and IIC, met its endpoints for intismeran autogene added to pembrolizumab.
The absolute gain is smaller than in stage III, most patients would never have relapsed, and around one in five who receive a PD-1 antibody has an immune side effect that is sometimes permanent, so guidelines list adjuvant therapy as an option to discuss rather than a default. Circulating tumour DNA, gene-expression profiles and the sentinel node itself are being studied to pick out the minority who will relapse, and the adjuvant COLUMBUS-AD trial is testing encorafenib-binimetinib in BRAF-mutant stage II disease.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
Each skin cancer comes from a different cell layer: melanocytes and basal cells at the base of the epidermis, keratinocytes above them, Merkel cells and blood vessels in the dermis; depth of invasion decides the risk.
Same organ: Melanoma, Basal cell carcinoma, Cutaneous squamous cell carcinoma, Merkel cell carcinoma, Kaposi sarcoma, Skin cancer (all types), BRAF V600-mutant melanoma, Stage III melanoma (after surgery), Advanced melanoma (unresectable stage III and stage IV), Mucosal melanoma, Acral melanoma, Advanced cutaneous squamous cell carcinoma, Locally advanced and metastatic basal cell carcinoma, Bowen's disease (squamous cell carcinoma in situ), Dermatofibrosarcoma protuberans
Also on OnCo: Symptoms and red flags · Early detection roadmap.
Wide local excision with margins set by thickness and sentinel lymph node biopsy for primaries over 0.8 mm or with ulceration.
One year of pembrolizumab (KEYNOTE-716) or nivolumab (CheckMate 76K), or observation after a shared decision about a modest benefit and immune side effects.
Intismeran autogene with pembrolizumab met its endpoints in INTerpath-001, which included stage IIB and IIC; regulatory review pending.
Skin and nodal examination and, for higher-risk disease, imaging at intervals; patient education on self-examination.
Country and place are remembered in this browser only. A postcode is sent to OpenStreetMap's Nominatim service to find coordinates when you press the button; nothing else leaves your device.
Nivolumab is a second approved adjuvant option for stage IIB and IIC melanoma with the same trade-offs as pembrolizumab.
Adjuvant pembrolizumab is approved for stage IIB and IIC melanoma, though the absolute benefit and lack of survival data make observation a reasonable alternative after discussion.
Stage IIB, IIC and III on this site's melanoma pages, and the recognition that stage IIIA has a better prognosis than stage IIB or IIC, come from this system.
Query for this cancer: (TITLE:"Stage IIB and IIC melanoma" OR ABSTRACT:"Stage IIB and IIC melanoma" OR TITLE:"High-risk stage II melanoma" OR ABSTRACT:"High-risk stage II melanoma" OR TITLE:"Thick node-negative melanoma" OR ABSTRACT:"Thick node-negative melanoma" OR TITLE:"Stage IIB/IIC melanoma" OR ABSTRACT:"Stage IIB/IIC melanoma") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Stage IIB and IIC melanoma, not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Persistent headache with extreme tiredness, nausea, dizziness on standing or low blood pressure. Vomiting, severe weakness or collapse is adrenal crisis.
No pharmacokinetic interactions expected (antibody). See the irAE guide for toxicity management.
Immunotherapy can attack hormone-producing glands: most often the thyroid (usually ending in an under-active thyroid needing lifelong tablets), and less often the pituitary (hypophysitis) or adrenal glands, which can be life-threatening if missed.
See all on the product pages:NivolumabPembrolizumab·Printable cards in the navigator
Newly diagnosed? Read the first 60 days with Stage IIB and IIC melanoma, then print the one-page appointment sheet with room for the answers.
Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.
Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record.
Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked.