Ep 05: SWOG S1404

In this conversation, James Larkin and Sapna Patel discuss the SWOG adjuvant study in melanoma. They cover topics such as the study design, the use of adjuvant anti-PD-1 therapy, the comparison with interferon and ipilimumab, and the potential side effects of adjuvant treatment. They also touch on the importance of risk-benefit discussions with patients and the need for biomarkers to predict toxicity. Overall, the study showed a benefit in recurrence-free survival with adjuvant pembrolizumab, but there was no significant overall survival benefit. Keywords SWOG adjuvant study, melanoma, adjuvant therapy, anti-PD-1, interferon, ipilimumab, side effects, risk-benefit discussion, biomarkers Takeaways The SWOG adjuvant study in melanoma showed a benefit in recurrence-free survival with adjuvant pembrolizumab. There was no significant overall survival benefit in the study. Adjuvant anti-PD-1 therapy is less toxic than adjuvant interferon or ipilimumab. Risk-benefit discussions with patients are important in the adjuvant setting. Biomarkers to predict toxicity would be helpful in guiding treatment decisions. Titles The need for biomarkers to predict toxicity Understanding the side effects of adjuvant treatment Titles The need for biomarkers to predict toxicity Understanding the side effects of adjuvant treatment Sound Bites "The SWOG S1404 study remains the largest adjuvant anti-PD-1 study completed in melanoma." "This study sort of gets buried, but maybe for other reasons, I can tell you there are probably important reasons to pay attention to it." "The risk of long-term irreversible side effects is a consideration in the adjuvant setting." Chapters 00:00 Introduction and Quickfire Questions 02:03 The SWOG adjuvant study: Recurrence-free survival benefit 04:52 The underappreciated importance of the study 11:26 Understanding the side effects of adjuvant treatment 15:39 The analogy of adjuvant therapy to a self-driving car 19:47 Patient perception of benefit and risk 20:16 Conclusion