Setting the bar for adjuvant treatment of melanoma

Mené au Royaume-Uni sur 1 343 patients atteints d'un mélanome cutané de stade avancé à haut risque de récidive, cet essai multicentrique de phase III évalue l'efficacité, du point de vue de la survie globale, et la toxicité du bévacizumab en traitement adjuvant (durée médiane de suivi: 25 mois)

Résumé en anglais

There is universal agreement about the need to improve adjuvant treatment for patients who have melanoma and are at high risk of disease recurrence after surgery. Medical management of metastatic melanoma has improved greatly, with the approval of four new drugs that have shown clear survival benefits in phase 3 randomised trials, beginning with the approvals of ipilimumab and vemurafenib in 2011. Effective adjuvant treatment—whether with approved drugs or those in development—is important to minimise melanoma recurrence and death. The American Society of Clinical Oncology has published guidance that aims to improve the standard of clinical trials in metastatic breast, colon, lung, and pancreatic cancers by setting a higher bar for treatment expectations. Where should the bar then be set for clinical trials of adjuvant treatment in patients with melanoma? How do the results of the AVAST-M trial, which assessed the role of bevacizumab as adjuvant treatment for patients with stage III melanoma at high risk of recurrence, help inform our deliberations?