Uitbreiding behandelarsenaal vraagt om doelmatigheid

The rapidly developing novel therapies for metastatic melanoma (stage IV) are now starting to prove their value in the adjuvant treatment of stage III melanoma. Two studies recently published in The New England Journal of Medicine , the CheckMate 238 study and the Combi-AD study, both show a significantly increased chance of recurrence-free survival for stage III melanoma patients. In the adjuvant setting, immunotherapy by checkpoint inhibition and targeted therapy may therefore become newly available therapeutic options. Pending EMA approval, this may prove to be good news for patients. In the Netherlands, continued critical appraisal of these expensive treatment modalities in metastatic melanoma is mandatory, as issued by the Dutch Government. This important documentation of expensive oncological therapeutics should also be carried out for adjuvant treatments by the expert centres that are experienced in the use and structured evaluation of these therapies.

Conflict of interest and financial support for this article: the author’s institution has received a fee from Novartis for training (ESMO 2017). Potential conflict of interest have been reported. An ICMJE form provided by the author is available online along with the full text of this article.