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- W2605722128 abstract "This patient ( 1 Barker C.A. Adjuvant therapy in high-risk stage III cutaneous melanoma. Int J Radiat Oncol Biol Phys. 2017; 98: 11-12 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar ) is at high risk for recurrence, even if treated with the best available adjuvant therapies. For melanoma patients presenting with palpable nodes >2 to 3 cm, we use upfront systemic therapy before or possibly even instead of lymphadenectomy. If a BRAF V600 mutation is identified, we treat with BRAF and MEK inhibitors for 6 months, followed by re-evaluation for lymphadenectomy. The response rate in this neoadjuvant setting is extremely high ( 2 Sloot S. Zager J.S. Kudchadkar R.R. et al. BRAF inhibition for advanced locoregional BRAF V600E mutant melanoma: A potential neoadjuvant strategy. Melanoma Res. 2016; 26: 83-87 Crossref PubMed Scopus (15) Google Scholar ). But because response to targeted therapy is often transient, we advocate lymphadenectomy routinely whenever technically possible (Fig. 1). After lymphadenectomy, we do not resume additional systemic therapy. For those without a BRAF mutation, we consider “upfront” immunotherapy using an anti-PD1–based approach, but we operate only selectively for persistent or progressive disease rather than routinely, as for neoadjuvant BRAF/MEK inhibition in BRAF mutant cases. Adjuvant Therapy in High-Risk Stage III Cutaneous MelanomaInternational Journal of Radiation Oncology, Biology, PhysicsVol. 98Issue 1PreviewA 69-year-old man presents with a 2-month history of an enlarging right groin mass. Seven years before presentation, he underwent wide local excision and sentinel lymph node biopsy for a pT4bN0M0R0 cutaneous melanoma of the right upper leg, 32 mm thick, ulcerated, with lymphovascular space invasion. He has no other significant medical history. Full-Text PDF" @default.
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- W2605722128 date "2017-05-01" @default.
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- W2605722128 title "Adjuvant and Neoadjuvant Therapy in High-Risk Stage III Cutaneous Melanoma" @default.
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- W2605722128 doi "https://doi.org/10.1016/j.ijrobp.2017.02.224" @default.
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