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Giving the immunotherapy doublet before surgery, instead of nivolumab after, cut the risk of recurrence by about two thirds and let most patients skip further treatment.
Presented at the ASCO 2024 plenary and published in NEJM (June 2024). 12-month EFS 83.7% vs 57.2%; HR for progression, recurrence or death 0.32. Around 59% of the neoadjuvant arm had a major pathological response and received no adjuvant therapy. The first phase 3 in oncology to test an immunotherapy-only neoadjuvant regimen against standard of care; adopted into NCCN and ESMO guidance as a preferred option for resectable nodal disease.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
423 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Event-free survival at 12 monthsprimary | Neoadjuvant ipilimumab + nivolumab | - | 83.7% | 0.32 | - | link |
| Adjuvant nivolumab | - | 57.2% |
Shares Treat the draining lymph node before removing it, Stage III melanoma (after surgery), Event-free / disease-free survival (EFS, DFS, iDFS, RFS), CTLA-4.
Shares Neoadjuvant immunotherapy → response-adapted adjuvant, Stage III melanoma (after surgery), Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Neoadjuvant / adjuvant / perioperative.
Shares Netherlands Cancer Institute (NKI-AvL), CTLA-4, Ipilimumab, Nivolumab.
Shares BRAF V600-mutant melanoma, CTLA-4, Ipilimumab, Nivolumab.
Shares Treat the draining lymph node before removing it, NADINA: two doses of ipilimumab plus nivolumab before surgery beat a year of nivolumab after surgery in stage III melanoma, Netherlands Cancer Institute (NKI-AvL), Ipilimumab.
Shares CTLA-4, Ipilimumab, Nivolumab, PD-1.
Shares Major pathological response (MPR), Stage III melanoma (after surgery), Ipilimumab, Nivolumab.
Shares Treat the draining lymph node before removing it, Stage III melanoma (after surgery), Ipilimumab, Nivolumab.