Adjuvant systemic treatment for high-risk resected non-cutaneous melanomas: What is the evidence?

• Published in: Critical reviews in oncology/hematology 2021-11, Vol.167, p.103503-103503, Article 103503
• Main Authors: Tapia Rico, Gonzalo, Yong, Chen Han, Herrera Gómez, Ruth Gabriela
• Format: Article
• Language: English
• Subjects: Adjuvant; Chemotherapy; Immunotherapy; Mucosal; Non-cutaneous melanoma; Risk of recurrence; Uveal
• ISSN: 1040-8428; 1879-0461
• DOI: 10.1016/j.critrevonc.2021.103503

[Display omitted] •Cutaneous and non-cutaneous melanomas are totally different clinical entities.•When possible, surgery represents the treatment cornerstone.•Adjuvant therapy for non-cutaneous melanomas remains a matter of debate.•Propose future research directions for these challenging disease entities. Non-cutaneous melanomas (mucosal, uveal, leptomeningeal, unknown primaries) represent around 5−10 % of all melanoma diagnoses. Non-cutaneous melanomas demonstrate differences in tumour biology, generally present with more advanced stages and have an overall poorer prognosis compared to skin melanomas. The cornerstone of their treatment is surgery followed by radiotherapy in some cases. Unfortunately, in many of these patients their melanoma will recur. Adjuvant therapy for non-cutaneous melanomas remains controversial. To date, almost all of the tested adjuvant agents have failed to demonstrate any benefit; the two randomised positive trials were criticized for methodological reasons, small sample size and conflicting results. The aim of this review is to assess the current evidence on systemic adjuvant treatments for high-risk resected non-cutaneous melanomas. We also provide a summary table with the currently recruiting clinical trials in these settings and we discuss some strategies to improve trial design in this particularly niche area of oncology.