Treatment of Amelanocytic Melanoma in Clinical and Resectable Stage IIIB–IV Cutaneous Melanoma
For patients with clinical and resectable stage IIIB–IV cutaneous melanoma, a perioperative systemic approach — integrating treatment before and after surgical resection — is the recommended strategy. The structured protocol below provides the full evidence-based regimen for this specific presentation.
Clinical scenario: Clinical and resectable stage IIIB–IV cutaneous amelanocytic melanoma — a high-risk presentation in which surgery alone is insufficient and perioperative systemic therapy is indicated per current evidence.
Treatment approach
The protocol applies a neoadjuvant immunotherapy strategy — systemic therapy administered before surgical resection — followed by the resection itself and then continued adjuvant immunotherapy postoperatively. The specific agent involved, the number of cycles at each phase, and full eligibility criteria are contained within the complete structured protocol.
Dosing schedule, treatment algorithm, and full regimen details available in the complete protocol.
References
DOI: 10.1200/JCO.23.01136
- Neoadjuvant pembrolizumab (maximum of three courses of 200 mg once every 3 weeks) followed by resection and adjuvant pembrolizumab (maximum of 15 courses of 200 mg once every 3 weeks) should be offered to patients with clinical and resectable stage IIIB-IV cutaneous melanoma.
- Preresection: pembrolizumab, maximum of 3 courses of 200 mg iv once every 3 weeks
- Postresection: pembrolizumab, maximum of 15 courses of 200 mg iv once every 3 weeks (SWOG S18018)
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