MISSION

The Group aims to improve the clinical care of patients suffering with cutaneous or ocular (eye) melanoma, and to increase knowledge about melanoma acquisition and progression. Group sub-committees focus on topics including epidemiology, early stage melanoma, surgery, pathology and systemic therapy (adjuvant and for advanced disease).

PRACTICE CHANGING RESEARCH

Melanoma is the deadliest form of skin cancer. Historically, melanoma was a rare cancer, but in the last 50 years its incidence has risen faster than almost any other cancer [1making it the 19th most commonly occurring cancer worldwide,[2] with over 320,000 new cases and over 55,000 deaths, in 2020. [3After Australia and New Zealand, European countries have highest rates of melanoma incidence. According to GLOBOCAN, in Europe there are approximately 144.000 cases diagnosed per year and 27.000 deaths related [4].   

Starting from pigment-producing cells (melanocytes) in the skin, melanoma spreads to other parts of the body through metastasis.  Patients with stage III melanoma usually undergo surgery to remove the primary tumour and the nearby metastasised lymph nodes (i.e., to which mobile tumour cells have migrated). However, successful surgery does not guarantee that patients will be cancer-free, and stage III melanoma patients bear a high risk that their cancer returns. 

Ipilimumab is an antibody-based drug that works as an immune checkpoint inhibitor and thereby increases anti-tumour immune responses. It was approved in 2011 for the treatment of advanced melanoma, at a dose of 3 mg per kilogram of body weight.[1,2] Based on research suggesting the potential for a higher dose to have higher efficacy (although at a cost of more toxic effects),[3,4] the EORTC 18071 study aimed to evaluate the effect of treating high-risk stage III melanoma patients with ipilimumab at a dose of 10 mg per kilogram – as compared with giving a placebo instead – after surgery to remove their primary tumour and nearby/affected lymph nodes. The study showed a significant (over 10%) increase in cancer recurrence-free survival with (‘high-dose’) ipilimumab treatment after 5 years, as compared with placebo.[5] Even though there were adverse effects reported with ipilimumab, overall, the drug did not have a negative effect on the patients’ health-related quality of life.[6] After 7 years, ipilimumab still showed durable recurrence-free survival as well as overall survival benefit, with an 8.7% absolute difference for overall survival. [7]

Study coordinator:  Prof. Alexander Eggermont 

STUDY INFORMATION
PUBLICATION
Pembrolizumab – an antibody-based ‘drug’ – has been shown to stimulate the body’s immune system to remove remaining melanoma cells. The EORTC KEYNOTE-054 study looked at the effect of treating stage III melanoma patients (after surgery) with pembrolizumab, as compared to giving a placebo instead. The study showed that pembrolizumab treatment yielded a significant (over 40%) reduction of these patients’ risk of melanoma recurrence or death after 1.25 years[1This outcome led to the approval of pembrolizumab (by EMA in 2018 and FDA in 2019) for use in treating high-risk stage III melanoma patients. Prolonged recurrence-free survival with this treatment was further confirmed after 3.5 years, with recurrence-free survival rate of 65% at that point in pembrolizumab-treated patients – which was then 16% higher than with placebo[2] Pembrolizumab therapy – given after surgery of the primary tumour – provides a clear and sustained relapse-free survival benefit to stage III melanoma patients and is still considered a viable treatment option to date.

Study coordinator: Prof. Robert Caroline 

STUDY INFORMATION
PUBLICATION

LATEST PUBLICATIONS

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