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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1861-1868 |
| Number of pages | 8 |
| Journal | Annals of Oncology |
| Volume | 29 |
| Issue number | 8 |
| DOIs | |
| State | Published - Jan 1 2018 |
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Keywords
- Immune checkpoint blockade
- Melanoma
- Neoadjuvant therapy
- Pathology
- Targeted therapy
ASJC Scopus subject areas
- Hematology
- Oncology
Cite this
Pathological assessment of resection specimens after neoadjuvant therapy for metastatic melanoma. / Tetzlaff, M. T.; Messina, J. L.; Stein, J. E.; Xu, X.; Amaria, R. N.; Blank, C. U.; Van De Wiel, B. A.; Ferguson, P. M.; Rawson, R. V.; Ross, M. I.; Spillane, A. J.; Gershenwald, J. E.; Saw, R. P.M.; Van Akkooi, A. C.J.; Van Houdt, W. J.; Mitchell, T. C.; Menzies, A. M.; Long, G. V.; Wargo, J. A.; Davies, M. A.; Prieto, V. G.; Taube, Janis M; Scolyer, R. A.
In: Annals of Oncology, Vol. 29, No. 8, 01.01.2018, p. 1861-1868.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pathological assessment of resection specimens after neoadjuvant therapy for metastatic melanoma
AU - Tetzlaff, M. T.
AU - Messina, J. L.
AU - Stein, J. E.
AU - Xu, X.
AU - Amaria, R. N.
AU - Blank, C. U.
AU - Van De Wiel, B. A.
AU - Ferguson, P. M.
AU - Rawson, R. V.
AU - Ross, M. I.
AU - Spillane, A. J.
AU - Gershenwald, J. E.
AU - Saw, R. P.M.
AU - Van Akkooi, A. C.J.
AU - Van Houdt, W. J.
AU - Mitchell, T. C.
AU - Menzies, A. M.
AU - Long, G. V.
AU - Wargo, J. A.
AU - Davies, M. A.
AU - Prieto, V. G.
AU - Taube, Janis M
AU - Scolyer, R. A.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - Immune checkpoint blockade
KW - Melanoma
KW - Neoadjuvant therapy
KW - Pathology
KW - Targeted therapy
UR - http://www.scopus.com/inward/record.url?scp=85055505227&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055505227&partnerID=8YFLogxK
U2 - 10.1093/annonc/mdy226
DO - 10.1093/annonc/mdy226
M3 - Article
C2 - 29945191
AN - SCOPUS:85055505227
VL - 29
SP - 1861
EP - 1868
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 8
ER -