Skin cancer patients benefit most from immunotherapy before surgery, study shows

Patients with metastatic skin cancer benefit in most cases from immunotherapy before surgery. Studies by Antoni van Leeuwenhoek show that 59 percent of patients treated in this order no longer required follow-up treatment. After one year, 84 percent of successfully treated patients were still tumor-free. This is a significantly higher percentage than in the control group that received the standard treatment (57 percent).

With the current standard treatment, patients with metastatic skin cancer have to undergo drug immunotherapy twelve times after an operation to remove the lymph nodes. Almost half of them develop the disease again within three to five years. The internist and oncologist Christian Blank from the Hospital for Cancer Diseases already suspected years ago that administering immunotherapy first and then operating could be more effective. Earlier studies that he conducted also indicated this.

The results he released on Sunday come from the largest study, among 423 patients from different countries. One group received the standard treatment, and the other group initially received two immunotherapy treatments with ipilimumab and nivolumab, followed by surgery.

The new method will also reduce the treatment duration for most patients, on average to six weeks. There are also financial benefits. "The treatment is much cheaper, 16,000 euros per patient instead of 68,000 euros," says Blank. According to his calculations, this leads to savings of around 30-40 million euros per year in the Netherlands. Worldwide, around 1 billion euros could be saved annually.

Immunotherapy has greatly improved the treatment of various types of cancer in recent years. This type of therapy strengthens the body's immune system's ability to destroy cancer cells. This approach differs from cancer treatments such as chemotherapy and radiotherapy, which have been used for some time. These target the tumor itself.

Blank presented his research findings on Sunday at a major conference for oncologists in Chicago. He has also published them in the New England Journal of Medicine.