Adjuvant Therapy for High-Risk Melanoma

Introduction High-risk resected melanoma signifies a group of patients that carries a risk of melanoma recurrence and death after initial surgical resection that may be defined as 35% to 40% or higher and includes patients with American Joint committee on cancer (AJcc) stages IIb, IIc, III, and IV. the development of local or regional recurrence after initial surgical management portends an even poorer prognosis.1-3 In the Melanoma Surgical trial, a local recurrence was associated with 5and 10-year survival rates of 9% to 11% and 5%, respectively. residual micrometastasis is thought to be the source of future melanoma recurrence and death. this is where systemic adjuvant therapy may alter the course of this disease, presenting an opportunity for relapse-free survival (rFS) and overall survival (oS) benefits. Various therapeutic modalities, including immunotherapy, chemotherapy, biochemotherapy, and local radiation therapy, have been tested in the adjuvant setting over the past 3 decades.