Stage III melanoma (after surgery): lines of therapy
5 standard-of-care settings across 2 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Resectable macroscopic nodal disease | Neoadjuvant ipilimumab plus nivolumab for two cycles then surgery, with adjuvant therapy only if the pathological response is poor (NADINA); or neoadjuvant then adjuvant pembrolizumab (SWOG S1801). | NCCN Guidelines: Melanoma: Cutaneous | 98 | |
| All comers | Adjuvant, after upfront surgery | One year of nivolumab (CheckMate 238) or pembrolizumab (KEYNOTE-054); dabrafenib-trametinib for one year is the alternative in BRAF V600-mutant disease (COMBI-AD). | NCCN Guidelines: Melanoma: Cutaneous | 98 | |
| All comers | Adjuvant vaccine (emerging) | Intismeran autogene with pembrolizumab met its endpoints in INTerpath-001 (2026); regulatory review pending. | 89 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Positive sentinel node, no palpable disease | Wide local excision, no completion lymph node dissection (MSLT-II), nodal ultrasound surveillance, then adjuvant systemic therapy. | NCCN Guidelines: Melanoma: Cutaneous | 79 | |
| All comers | In-transit disease | Excision where feasible; intralesional talimogene laherparepvec or the immunocytokine daromun before surgery; isolated limb perfusion for extensive limb disease. | NCCN Guidelines: Melanoma: Cutaneous | 81 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.