@article{be601608277c409e963205ab7c60a98b,
title = "Pathological assessment of resection specimens after neoadjuvant therapy for metastatic melanoma",
abstract = "Background: Clinical trials have recently evaluated safety and efficacy of neoadjuvant therapy among patients with surgically resectable regional melanoma metastases. To capture informative prognostic data connected to pathological response in such trials, it is critical to standardize pathologic assessment and reporting of tumor response after this treatment. Methods: The International Neoadjuvant Melanoma Consortium meetings in 2016 and 2017 assembled pathologists from academic centers to develop consensus guidelines for pathologic examination and reporting of surgical specimens from AJCC (8th edition) stage IIIB/C/D or oligometastatic stage IV melanoma patients treated with neoadjuvant-targeted or immune therapy. Patterns of pathologic response are provided context to inform these guidelines. Results: Based on our collective experience and guided by efforts in well-established neoadjuvant settings like Breast cancer, procedures directing handling of pre- and post-neoadjuvant therapy–treated melanoma specimens are provided to facilitate comparison of findings across different trials and centers. Definitions of pathologic response are provided together with guidelines for reporting and quantifying the extent of pathologic response. Finally, the spectrum of histopathologic responses observed following neoadjuvant-targeted and immune-checkpoint therapy is described and illustrated. Conclusions: Standardizing pathologic evaluation of resected melanoma metastases following neoadjuvant-targeted or immune-checkpoint therapy allows more robust stratification of patient outcomes. This includes recognizing the spectrum of histopathologic response patterns to neoadjuvant therapy and a standard approach to grading pathologic responses. Such an approach will facilitate comparison of results across clinical trials and inform ongoing correlative studies into the mechanisms of response and resistance to agents applied in the neoadjuvant setting.",
keywords = "Immune checkpoint blockade, Melanoma, Neoadjuvant therapy, Pathology, Targeted therapy",
author = "Tetzlaff, {M. T.} and Messina, {J. L.} and Stein, {J. E.} and X. Xu and Amaria, {R. N.} and Blank, {C. U.} and {Van De Wiel}, {B. A.} and Ferguson, {P. M.} and Rawson, {R. V.} and Ross, {M. I.} and Spillane, {A. J.} and Gershenwald, {J. E.} and Saw, {R. P.M.} and {Van Akkooi}, {A. C.J.} and {Van Houdt}, {W. J.} and Mitchell, {T. C.} and Menzies, {A. M.} and Long, {G. V.} and Wargo, {J. A.} and Davies, {M. A.} and Prieto, {V. G.} and Taube, {J. M.} and Scolyer, {R. A.}",
note = "Funding Information: Supported in part by The University of Texas MD Anderson Cancer Center Melanoma Moon Shots Program. This work was also supported by the Melanoma Research Alliance (JMT), Harry J. Lloyd Trust (JMT), National Cancer Institute R01 CA142779 (JMT), and The Bloomberg-Kimmel Institute for Cancer Immunotherapy. Support from colleagues at Melanoma Institute Australia is also gratefully acknowledged. GVL and RAS are supported by the Australian National Health and Medical Research Council Practitioner Fellowship program (no grant number applies). JES was supported by a T32 training grant to Johns Hopkins (grant number NIH T32 CA193145). Funding Information: MTT (Advisory Board with Myriad Genetics, Novartis, Seattle Genetics); RNA (research funding from Bristol Myers Squibb); CB (advisory board with Bristol Myers Squibb, Merck, Roche, Novartis, GlaskoSmithKline, Pfizer, Lilly; Research grants: Bristol Meyers Squibb, Novartis); MIR (consultancy with Merck and AMGEN; Speaker for AMGEN and Provectus; Advisopry Board Merck, AMGEN, Provectus, Castle Biosciences, GlaskoSmithKline); RPMS (education honoraria BMS, advisory board Novartis); TM (honorarium from Merck for scientific advisory committee, advisory for Bristol Myers Squibb and Incyte); GVL (Consultant Advisor: Amgen, Bristol Myers Squibb, Merck MSD, Novartis, Roche, Pierre Fabre, Array and Honoraria from Bristol Myers Squibb, Merck MSD, Novartis, Roche); MAD (PI of research grants MDACC from GlaskoSmithKline, Roche-Genentech, Bristol Myers Squibb, Merck, Astrazeneca, Sanofi-Aventis, Oncothyreon, Myriad; Consultant for Novartis, GlaskoSmithKline, Roche-Genentech, Bristol Myers Squibb, Sanofi-Aventis, Vaccinex, and Syndax); VGP (Advisory Board with Myriad and Novartis); JAW (Compensation for speaker{\textquoteright}s bureau and honoraria from Dava Oncology, Bristol-Myers Squibb and Illumina; Advisory committees for GlaxoSmithKline, Roche/Genentech, Novartis and AstraZeneca); JMT (Advisory board/consultant for Bristol Myers Squibb, Astra-Zeneca, Merck, Amgen Investigator-initiated research funding from Bristol Myers Squibb); JEG (Advisory board/consultant for Merck, Syndax, Castle Biosciences, Novartis, and Bristol Myers Squibb). All remaining authors have declared no conflicts of interest.",
year = "2018",
doi = "10.1093/annonc/mdy226",
language = "English (US)",
volume = "29",
pages = "1861--1868",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "Oxford University Press",
number = "8",
}