Resectable Stage III Cutaneous Melanoma with Pathologically Proven, Clinically or Radiologically Detectable Lymph Node Metastasis: Treatment

This protocol addresses patients with resectable stage III cutaneous melanoma in whom lymph node metastasis has been pathologically confirmed and remains clinically or radiologically detectable — a population for whom the integration of systemic therapy before surgery is a key management question.

Clinical Scenario

Resectable stage III cutaneous melanoma with biopsy-confirmed lymph node involvement that is clinically or radiologically detectable. The resectability and nodal staging define this as a population eligible for a perioperative systemic treatment strategy.

Treatment Approach

A neoadjuvant immunotherapy combination administered before definitive surgical resection is recommended for this population. The complete regimen options, sequencing, and subsequent management steps are detailed in the full protocol.

Treatment Goal

The primary target is achieving a major pathological response (MPR), defined according to INMC criteria. Pathological response assessment at surgery directly informs adjuvant treatment decisions.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2024.11.006

For patients with resectable stage III melanoma and pathologically proven, clinically or radiologically detectable LN metastasis, neoadjuvant nivolumabeipilimumab [ESMO-MCBS v1.1 score: A; not EMA or FDA approved] followed by surgery should be offered.

For patients with an MPR defined according to INMC criteria, adjuvant treatment can be omitted.

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