Significant Long-Term Survival Rates in Stage III Melanoma from Pre-Surgery Immunotherapy

In a groundbreaking study led by researchers at The University of Texas MD Anderson Cancer Center, a novel combination of immune checkpoint inhibitors—nivolumab and relatlimab—has demonstrated remarkable effectiveness in increasing long-term survival rates for patients diagnosed with stage III melanoma. Four years post-treatment, 87% of patients remained alive, with 80% experiencing no recurrence of their cancer, according to findings published in the Journal of Clinical Oncology on July 12, 2025.

The Phase II trial, which involved 30 patients, highlighted the importance of pre-surgical immunotherapy, also known as neoadjuvant therapy. This approach not only shrinks tumors before surgery but also primes the immune system to prevent future recurrences, a significant concern for stage III melanoma patients due to its high risk of post-surgical relapse.

Dr. Elizabeth Burton, the study's corresponding author and executive director of MD Anderson’s Strategic Research Initiative Development (STRIDE) program, noted the implications of these findings. "If immunotherapy eliminates most of the tumor before surgery, we have sufficiently trained the immune system for an antitumor response, which minimizes the possibility of recurrence," she stated. Burton emphasized the potential of this treatment to enhance patient outcomes and advance research into the mechanisms driving treatment responses.

The study also identified biomarker potential, with patients exhibiting high pre-treatment levels of TIGIT or low levels of B7-H3 showing the best chances for remaining recurrence-free. This suggests that these biomarkers could serve as predictive tools for future treatments, further individualizing patient care.

Dr. Hussein Tawbi, a professor of Melanoma Medical Oncology and co-senior author of the study, pointed out that this trial was the first to evaluate the nivolumab-relatlimab combination in a neoadjuvant setting for early-stage melanoma. The Food and Drug Administration (FDA) had already approved this combination in 2022 for advanced melanoma based on earlier trials, specifically the Phase II/III RELATIVITY-047 clinical trial, which demonstrated its safety and efficacy.

The implications of these findings extend beyond individual patient care. The study was conducted with support from Bristol Myers Squibb and MD Anderson's Moon Shots Program, emphasizing the collaborative effort required in advancing cancer treatment. The research team plans to further validate the identified biomarkers and explore their impact on the tumor microenvironment through collaborations with the James P. Allison Institute at MD Anderson.

Overall, this research represents a significant step forward in the management of stage III melanoma, offering hope for enhanced survival rates and a better understanding of the biological mechanisms involved in immunotherapy responses. As the field of oncology continues to evolve, such studies pave the way for more effective, personalized treatment strategies that could alter the landscape of cancer care in the coming years.