Expert highlights from the 2023 Nordic Melanoma Meeting

The Nordic melanoma meeting was held October 11–13 in Reykjavik and brought together Nordic and international clinicians and researchers. Pierre Fabre’s oncology team was on site and caught up with Professor Roger Olofsson Bagge and Professor Lars Ny to discuss what they considered highlights from the meeting.

Both Professor Roger Olofsson Bagge and Professor Lars Ny agreed that the meeting was of great importance for melanoma research in the Nordics and presented a key platform for networking and the establishment of long-term collaborations.

This year a crux of the discussion was how to select treatment for melanoma patients in the future and especially the role of adjuvant immunotherapy. This discussion was initiated by Associate Professor Jason Luke’s presentation, showing that stage II melanoma patients receiving adjuvant immunotherapy experience similar benefits in recurrence-free survival as stage III patients.1,2 Subsequently, Associate Professor Hildur Helgadottir presented new data from the Swedish National registry that show no benefit of adjuvant immunotherapy on overall survival in the Swedish context.3 The presentations by Dr. Neel Maria Helvind and Dr. Ylva Naeser showed that radiological follow up for early detection of metastases did not lead to better outcomes compared to the standard clinical follow up.4,5 further underlined the need to rethink melanoma care.

Professor Roger Olofsson Bagge “Just a few years ago no one questioned adjuvant therapy, we all assumed that longer recurrent free survival would automatically translate into longer overall survival. We now see this is not the case. The question is how the Nordics will react — will they change the treatment guidelines now when adjuvant therapy is already implemented?”

The cross-disciplinarity of the meeting was especially evident in the presentation by Professor Richard White, showing that in zebrafish cellular context beyond genetic mutations is key for melanoma development.6,7 While far from the clinical practice it showed that there are still knowledge gaps in our understanding of melanoma. This was an underlying theme of Professor Christian Blank’s presentation as well, as he highlighted the need for a more precise or personalized treatment.8 The new prognostic application, developed by the Swedish melanoma register was highlighted as a tool for advancing towards higher treatment precision.9

Professor Lars Ny “We need to better identify high-risk patients, and I think that in the future we will have tools like molecular profiling, supporting the pathology and clinical disease picture. Allowing us to base treatment on more than the clinical staging.”

Turning the focus on the future, both agreed that the presentation by Professor Inge Marie Svane was a highlight. Her presentation focused on the opportunities offered by tumor infiltrating lymphocytes (TIL) therapy and cancer vaccination strategies in boosting immune responses in cancer treatment.10, 11, 12

Professor Lars Ny “It was great to hear Inge Marie Svane talk about how the concept has achieved such broad acceptance in Denmark. They are pioneers in the Nordics and Europe in the implementation of these advanced treatments.”

The discussion of the future of advanced melanoma treatments was also a key topic of the coffee break discussions: especially how clinical trials in the Nordics could be organized, building further on the Swedish–Finnish collaboration for uveal melanoma treatment.

Professor Roger Olofsson Bagge “Lately, we haven’t been good at doing joint clinical trials within the Nordic countries, and with more advanced treatment in the near future, we should discuss if Nordic centers of excellence should be established for some of these treatments. Now is really the time when we should start working together.”

Pierre Fabre thanks the organizers for an excellent meeting and wishes to see everyone again at the next Nordic Melanoma Meeting, 2025 in Tromsø Norway.

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Uppdaterad: 19 mars, 2024
Referenser
1 Luke JJ et al. Pembrolizumab versus placebo as adjuvant therapy in completely resected stage IIB or IIC melanoma (KEYNOTE-716): a randomised, double-blind, phase 3 trial. The Lancet, 2022, 399(10336)
2 Georgina V et al. Pembrolizumab versus placebo as adjuvant therapy in resected stage IIB or IIC melanoma (KEYNOTE-716): distant metastasis-free survival results of a multicentre, double-blind, randomised, phase 3 trial Long. The Lancet Oncology, 2022, 23(11)
3 Helgadottir H, et al. Survival after introduction of adjuvant treatment in stage III melanoma: a nationwide registry-based study, JNCI: Journal of the National Cancer Institute, 2023, 115(9)
4 Helvind NM et al. Stage-Specific Risk of Recurrence and Death from Melanoma in Denmark, 2008-2021: A National Observational Cohort Study of 25 720 Patients With Stage IA to IV Melanoma. JAMA Dermatol. 2023.
5 Naeser Y et al. Quality of Life in the First Year of Follow-Up in a Randomized Multicenter Trial Assessing the Role of Imaging after Radical Surgery of Stage IIB-C and III Cutaneous Melanoma (TRIM Study). Cancers. 2022, 14(4)
6 Arianna B et al. Developmental chromatin programs determine oncogenic competence in melanoma. Science 2023, 373
7 Weiss JM et al. Anatomic position determines oncogenic specificity in melanoma. Nature 2022, 604,
8 Lucas MW et al. Personalizing neoadjuvant immune-checkpoint inhibition in patients with melanoma. Nat Rev Clin Oncol 2023, 20
9 Lyth, Johan et al. Population-based prognostic instrument (SweMR 2.0) for melanoma-specific survival - An ideal tool for individualised treatment decisions for Swedish patients. European Journal of Surgical Oncology, 2023, 49(10)
10 Lorentzen CL et al., Clinical advances and ongoing trials of mRNA vaccines for cancer treatment, The Lancet Oncology, 2022, 23(10)
11 Monberg TJ et al., TIL Therapy: Facts and Hopes. Clinical Cancer Research, 2023 29(17)
12 Mørk SK et al. First in man study: Bcl-Xl_42-CAF®09b vaccines in patients with locally advanced prostate cancer. Frontiers in Immunology. 2023, 14.
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