Immunotherapy as the body's 'personal trainer' and melanoma is the gymnasium
The new frontier is adjuvant and neo-adjuvant therapy: treatment is administered before or immediately after surgery to 'train' the immune system to recognise and destroy any residual tumour cells
Over the last fifteen years, metastatic melanoma has become the paradigm of the transformation that immunotherapy has brought to clinical oncology. Whereas until recently an advanced diagnosis was associated with a life expectancy of only a few months, today the scenario is radically different. Thanks to immune checkpoint inhibitors, the immune system is no longer a passive bystander, but a central player in the control of the disease and, in some cases, the cure.
Melanoma as a laboratory
Of all cancers, melanoma is certainly the one against which advances in immunotherapy have immediately produced relevant clinical results. Research is moving forward rapidly, offering new hope especially to those who had none only 10 or 20 years ago. Melanoma has been the world laboratory in this respect. The success rates of modern treatments speak for themselves: almost half of all patients with an advanced stage now look to the future.
These results and new research perspectives are the focus of the annual conference of the Campania Society of Oncological Immunotherapy (SCITO), which brings together in Naples specialists involved in the development and clinical application of the most advanced immunotherapy strategies.
The leap of survival
Here the quantum leap is impressive. Before the advent of immune checkpoint inhibitors, 5-year survival for Stage IV melanoma was less than 10%. Today, data from the CheckMate 067 clinical trial show a completely different reality: the combined use of two immunotherapy drugs, nivolumab and ipilimumab, has increased 10-year overall survival to 43%. For those who achieve a complete response, the probability of being alive at 5 years exceeds 85%, with many patients even being able to discontinue treatment. Even in more complex cases, such as asymptomatic brain metastases, the immunotherapy combination has shown response rates of around 50%, a figure unthinkable a decade ago.
The New Frontiers
But immunotherapy is not only saving those in advanced stages. The new frontier is adjuvant and neoadjuvant therapy: administering treatment before or immediately after surgery to 'train' the immune system to recognise and destroy any residual tumour cells. In the CheckMate 238 study, 3-year recurrence-free survival increased to 58%, dramatically reducing the risk of the disease returning.
