HPA Oncology Unit first in Portugal using adjuvant immunotherapy for operated melanoma
Hospital Particular do Algarve – Gambelas Day Care Hospital is performing, for the first time in Portugal, adjuvant treatment with immunotherapy – Nivolumab (Opdivo®) – in an operated stage III melanoma patient.
This new indication (approved by the FDA since December 2017) is a big step forward in the treatment of this aggressive disease with a high likelihood of relapsing after surgery. In Europe, there was no standard care for adjuvant treatment after melanoma surgery.
In the US, Ipilimumab (Yervoy®) has been approved since 2015 for high-risk patients but came with a burden of high toxicity. The study CheckMate-238 compared Nivolumab versus Ipilimumab and revealed a highly significant reduction in relapsing disease and death risk in resected stage III (melanoma with nodal involvement). After this approval, very recently more evidence surfaced from the KEYNOTE-054 study, showing a similar benefit of Pembrolizumab (Keytruda®), another immunotherapy agent, in similar patients.
So, we are moving from the already ongoing major indications and approvals of immunotherapy in advanced (metastatic/stage IV) cancer – melanoma, lung cancer, kidney cancer, Hodgkin’s lymphoma, head and neck cancer – to other types of cancer including early-stage cancer, which means we are able to reduce the risk of a relapse of this lethal disease after curative surgery, without significant toxicities.
This can be explained by the way these drugs work on the system. Instead of having a direct cytotoxic effect on the cancer cells (as well as on healthy ones) as is the case with chemotherapy, immunotherapy which is also an intravenous drug, acts by unblocking the inhibition of our immune system (caused by the cancer) and stimulates its cytotoxic action.
So, with a simple one-hour intravenous administration, the treatment is administered with a very manageable toxicity result. Currently, hundreds of trials are exploring the potential of this treatment in the early stages of cancer, either alone or in combination with other standard treatments, with very promising results.
The HPA is proud of having its Oncology Unit providing patients with the latest cancer care and treatment available.
By Dr André Miguel Cruz
Dr André Miguel Cruz is an Oncologist working at Hospital Particular do Algarve – Alvor and Gambelas