Ep 12: PRADO

Summary In this conversation, James Larkin and Sapna Patel discuss the PRADO study, which focuses on neoadjuvant therapy for melanoma. The study explores the use of personalized response-driven approaches to treatment, based on the patient's response to combination immunotherapy. The study found that patients with a major pathological response had a low rate of recurrence in the first two years, suggesting a favorable outcome. However, there were still some patients who experienced recurrence, particularly those with multiple clinically positive lymph nodes. The discussion also touches on the challenges of defining and categorizing pathological response and the importance of accurate sampling and analysis. Keywords PRADO, neoadjuvant therapy, melanoma, personalized response-driven approach, major pathological response, recurrence, lymph nodes, sampling, analysis Takeaways The PRADO study explores personalized response-driven approaches to neoadjuvant therapy for melanoma. Patients with a major pathological response had a low rate of recurrence in the first two years. Patients with multiple clinically positive lymph nodes may require additional surgery to reduce the risk of recurrence. Defining and categorizing pathological response can be challenging and may vary across tumor types. Accurate sampling and analysis are crucial for evaluating pathological response. Sound Bites "Patients with a major pathological response had an excellent response." "Patients with multiple clinically positive lymph nodes may require additional surgery." "The definition of pathological response is not uniform across tumor types." Chapters 00:00 Introduction and Favorite Recording Artists 02:30 Background and Importance of the Prado Study 07:00 Categorizing Pathological Responses and Cherry Picking Lymph Nodes 08:38 Hypotheses and Outcomes for Major Pathologic Response 11:42 Setting Cutoffs and the Role of Sampling in Pathology 23:42 Global Impact of the PRADO Study and the Need for Adjuvant Therapy