Sustained Benefits of Neoadjuvant Immunotherapy in Resectable Melanoma

Recent 2025 data confirm that neoadjuvant immunotherapy provides durable benefits in patients with resectable stage III or IV melanoma. The phase III NADINA trial showed that preoperative nivolumab plus ipilimumab significantly improved 2-year event-free survival (EFS) (77.3% vs 55.7%; HR 0.40) and distant metastasis-free survival (DMFS) compared with adjuvant-only therapy, particularly in high-risk patients. Similarly, updated results from the SWOG S1801 trial demonstrate superior 3-year event-free survival (EFS) (68% vs 56%) and relapse-free survival (RFS) (80% vs 60%) with neoadjuvant-adjuvant pembrolizumab. Emerging biomarker analyses, including the NeoPredict model combining clinical, RNA, and DNA features, are beginning to identify patients most likely to benefit from neoadjuvant therapy, supporting more personalised strategies. These findings reinforce a paradigm shift, positioning neoadjuvant immunotherapy as a central approach for eligible patients with resectable melanoma.