If clinicians could determine if and when a given melanoma is most likely to metastasize, they could optimize treatment for the patient. A new data analysis proposes strategies for predicting metastasis and implementing post-surgical adjuvant treatment.
Published in Oncotarget, the new research perspective considers factors like metastasis initiation and tumor doubling time (TDT) and concludes that metastasis often had occurred before a primary melanoma is diagnosed.
The authors argue for initiation of adjuvant therapy in patients with high-risk primaries (i.e. those with Stage IIB and IIC melanomas) before waiting for dissemination of metastatic disease to be evident.

“Although it is yet to be definitively confirmed, it seems that immunotherapy is more likely to be effective at eliminating metastatic disease if the tumor burden is low, making it more logical to treat patients with high risk melanomas at the earliest possible time, rather than treating those who develop metastatic disease with the same drugs later, when the metastases have progressed from micrometastases to become secondary tumors able to be diagnosed clinically or by imaging,” the authors conclude.