Caroline Robert, MD, PhD

The paper’s invited discussant, Caroline Robert, MD, PhD, of the Institut de Cancérologie Gustave Roussy, Villejuif, France, said OpACIN-neo attained its goal of reducing toxicity and maintaining efficacy. The regimen of two courses of ipilimumab (Yervoy) at 1 mg/kg plus nivolumab (Opdivo) at 3 mg/kg maintained high clinical responses and decreased grade 3 to 4 toxicity from 90% to 20%, she said.

Dr. Robert agreed that a neoadjuvant immunotherapy approach is rational in melanoma, pointing out that it has been shown in animal models to increase tumor-specific CD8-positive T cells. “We know we are in a period of paradigm-shifting, including in this context in place of surgery,” she said. The achievement of a pathologic response, in several other cancer types, has predicted for relapses but not overall survival. “In this study, the follow-up is too short to know if pathologic responses will predict for better survival,” she said. “We look forward to seeing if it does…. The long-term benefit of pathologic complete response remains to be proven.” ■

DISCLOSURE: Dr. Robert has served as a consultant to Roche, Novartis, Bristol-Myers Squibb, MSD, Pierre Fabré, Array and Effector.