Blank and Lucas et al. report that two cycles of neoadjuvant ipilimumab plus nivolumab followed by therapeutic lymph node dissection and response-driven adjuvant nivolumab resulted in longer event-free survival (EFS) than the standard adjuvant nivolumab among patients with resectable, macroscopic, stage III melanoma. At a median follow-up of 9.9 months, the estimated 12-month EFS was 83.7% in the neoadjuvant group and 57.2% in the adjuvant group. Grade 3 or higher adverse events related to systemic treatment occurred in 29.7% of patients in the neoadjuvant group and 14.7% in the adjuvant group.
Contributed by Shishir Pant
Author Info: (1) From the Departments of Medical Oncology (C.U.B., M.W.L., L.L.H., J.M.L., S.M.P., J.B.A.G.H., K.A.T.N., J.V.T., S.W., A.M.-E., I.L.M.R.), Pathology (B.A.W.), Biometrics (M.L.-Y
Author Info: (1) From the Departments of Medical Oncology (C.U.B., M.W.L., L.L.H., J.M.L., S.M.P., J.B.A.G.H., K.A.T.N., J.V.T., S.W., A.M.-E., I.L.M.R.), Pathology (B.A.W.), Biometrics (M.L.-Y., A.T.A., L.G.G.-O.), Surgical Oncology (W.J.H., A.M.J.K., A.C.J.A.), Head and Neck Surgery (W.M.C.K., C.L.Z.), Radiology (B.A.S.), and Molecular Oncology and Immunology (J.B.A.G.H.), Netherlands Cancer Institute, and the Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam (A.J.M.E.), Amsterdam, the Departments of Medical Oncology (C.U.B., J.B.A.G.H., F.M.S., E.K.) and Otorhinolaryngology Head and Neck Surgery (C.L.Z.), Leiden University Medical Center, Leiden, the Departments of Medical Oncology (K.A.T.N., R.C.S., A.A.M.V.), Surgical Oncology (D.J.G., R.C.S.), and Radiology and Nuclear Medicine (A.A.M.V.), Erasmus Medical Center, Rotterdam, the Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht (S.B.V., K.P.M.S.), the Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden (R.R.), the Department of Medical Oncology, Zuyderland Medical Center, Sittard-Geleen (F.W.P.J.B.), the Department of Medical Oncology, Medisch Spectrum Twente, Enschede (D.P.), the Department of Medical Oncology, Maxima Medical Center, Veldhoven (G.V.), the Department of Medical Oncology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht (M.J.B.A.), the Department of Medical Oncology, Amphia Hospital, Breda (M.A.M.S.B.), the Department of Medical Oncology, Radboud University Medical Center, Nijmegen (M.J.B.-S.), the Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen (G.A.P.H.), and Isala Oncology Center, Isala Hospital, Zwolle (J.-W.B.G.) - all in the Netherlands; the Department of Hematology and Medical Oncology, University Clinic Regensburg, Regensburg, Germany (C.U.B.); Melanoma Institute Australia (R.A.S., A.M.M., R.P.M.S., N.G.M., M.G., S.N.L., A.S., T.E.P., K.F.S., R.V.R., S.C., J.S., M.A.R., A.C.J.A., M.S.C., G.V.L.), the Faculty of Medicine and Health (R.A.S., A.M.M., R.P.M.S., N.G.M., S.N.L., A.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A., G.V.L.), and Charles Perkins Centre (R.A.S., G.V.L.), University of Sydney, the Departments of Tissue Pathology and Diagnostic Oncology (R.A.S., R.V.R.) and Melanoma and Surgical Oncology (R.P.M.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A.), Royal Prince Alfred Hospital, NSW Health Pathology (R.A.S., R.V.R.), the Departments of Medical Oncology (A.M.M., G.V.L.) and Breast and Melanoma Surgery (A.S.), Royal North Shore and Mater Hospitals, and the Department of Radiology, Mater Hospital (R.K.), Sydney, Royal Prince Alfred Hospital, Institute of Academic Surgery, Camperdown, NSW (A.C.J.A.), the Division of Cancer Surgery, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC (D.E.G.), the Department of Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC (L.S., S.S.), Lake Macquarie Oncology, Lake Macquarie Private Hospital, the Department of Medical Oncology, Calvary Mater Hospital, and the Department of Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW (A.W.), the Department of Medical Oncology, Princess Alexandra Hospital, University of Queensland, Brisbane (V.A.), the Department of Medical Oncology, Fiona Stanley Hospital, Perth, WA (M.K.), the Department of Medical Oncology, Alfred Health, Melbourne, and the Department of Medicine, School of Translational Medicine, Monash University, Melbourne, VIC (M.C.A.), and the Department of Medical Oncology, Westmead Hospital and Blacktown, Sydney (M.S.C.) - all in Australia; the Melanoma Clinic, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (J.B.A.G.H.); the Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland (J.P., P.R.); the Department of Medical Oncology, Centre Lon Brard, Lyon (M.A.-A.), Universit Paris Cit, Assistance Publique-Hpitaux de Paris (AP-HP) Dermato-Oncology and Clinical Investigation Center, Cancer Institute AP-HP, Nord Paris Cit, INSERM Unit 976, Saint Louis Hospital, Paris (C.L.), and the Department of Medical Oncology, Gustave Roussy and Paris-Saclay University, Villejuif (C.R.) - all in France; the Department of Surgical Oncology, Angeles Clinic and Research Institute, Los Angeles (M.B.F.); and the Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy (P.A.A.). (2) From the Departments of Medical Oncology (C.U.B., M.W.L., L.L.H., J.M.L., S.M.P., J.B.A.G.H., K.A.T.N., J.V.T., S.W., A.M.-E., I.L.M.R.), Pathology (B.A.W.), Biometrics (M.L.-Y., A.T.A., L.G.G.-O.), Surgical Oncology (W.J.H., A.M.J.K., A.C.J.A.), Head and Neck Surgery (W.M.C.K., C.L.Z.), Radiology (B.A.S.), and Molecular Oncology and Immunology (J.B.A.G.H.), Netherlands Cancer Institute, and the Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam (A.J.M.E.), Amsterdam, the Departments of Medical Oncology (C.U.B., J.B.A.G.H., F.M.S., E.K.) and Otorhinolaryngology Head and Neck Surgery (C.L.Z.), Leiden University Medical Center, Leiden, the Departments of Medical Oncology (K.A.T.N., R.C.S., A.A.M.V.), Surgical Oncology (D.J.G., R.C.S.), and Radiology and Nuclear Medicine (A.A.M.V.), Erasmus Medical Center, Rotterdam, the Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht (S.B.V., K.P.M.S.), the Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden (R.R.), the Department of Medical Oncology, Zuyderland Medical Center, Sittard-Geleen (F.W.P.J.B.), the Department of Medical Oncology, Medisch Spectrum Twente, Enschede (D.P.), the Department of Medical Oncology, Maxima Medical Center, Veldhoven (G.V.), the Department of Medical Oncology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht (M.J.B.A.), the Department of Medical Oncology, Amphia Hospital, Breda (M.A.M.S.B.), the Department of Medical Oncology, Radboud University Medical Center, Nijmegen (M.J.B.-S.), the Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen (G.A.P.H.), and Isala Oncology Center, Isala Hospital, Zwolle (J.-W.B.G.) - all in the Netherlands; the Department of Hematology and Medical Oncology, University Clinic Regensburg, Regensburg, Germany (C.U.B.); Melanoma Institute Australia (R.A.S., A.M.M., R.P.M.S., N.G.M., M.G., S.N.L., A.S., T.E.P., K.F.S., R.V.R., S.C., J.S., M.A.R., A.C.J.A., M.S.C., G.V.L.), the Faculty of Medicine and Health (R.A.S., A.M.M., R.P.M.S., N.G.M., S.N.L., A.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A., G.V.L.), and Charles Perkins Centre (R.A.S., G.V.L.), University of Sydney, the Departments of Tissue Pathology and Diagnostic Oncology (R.A.S., R.V.R.) and Melanoma and Surgical Oncology (R.P.M.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A.), Royal Prince Alfred Hospital, NSW Health Pathology (R.A.S., R.V.R.), the Departments of Medical Oncology (A.M.M., G.V.L.) and Breast and Melanoma Surgery (A.S.), Royal North Shore and Mater Hospitals, and the Department of Radiology, Mater Hospital (R.K.), Sydney, Royal Prince Alfred Hospital, Institute of Academic Surgery, Camperdown, NSW (A.C.J.A.), the Division of Cancer Surgery, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC (D.E.G.), the Department of Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC (L.S., S.S.), Lake Macquarie Oncology, Lake Macquarie Private Hospital, the Department of Medical Oncology, Calvary Mater Hospital, and the Department of Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW (A.W.), the Department of Medical Oncology, Princess Alexandra Hospital, University of Queensland, Brisbane (V.A.), the Department of Medical Oncology, Fiona Stanley Hospital, Perth, WA (M.K.), the Department of Medical Oncology, Alfred Health, Melbourne, and the Department of Medicine, School of Translational Medicine, Monash University, Melbourne, VIC (M.C.A.), and the Department of Medical Oncology, Westmead Hospital and Blacktown, Sydney (M.S.C.) - all in Australia; the Melanoma Clinic, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (J.B.A.G.H.); the Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland (J.P., P.R.); the Department of Medical Oncology, Centre Lon Brard, Lyon (M.A.-A.), Universit Paris Cit, Assistance Publique-Hpitaux de Paris (AP-HP) Dermato-Oncology and Clinical Investigation Center, Cancer Institute AP-HP, Nord Paris Cit, INSERM Unit 976, Saint Louis Hospital, Paris (C.L.), and the Department of Medical Oncology, Gustave Roussy and Paris-Saclay University, Villejuif (C.R.) - all in France; the Department of Surgical Oncology, Angeles Clinic and Research Institute, Los Angeles (M.B.F.); and the Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy (P.A.A.). (3) From the Departments of Medical Oncology (C.U.B., M.W.L., L.L.H., J.M.L., S.M.P., J.B.A.G.H., K.A.T.N., J.V.T., S.W., A.M.-E., I.L.M.R.), Pathology (B.A.W.), Biometrics (M.L.-Y., A.T.A., L.G.G.-O.), Surgical Oncology (W.J.H., A.M.J.K., A.C.J.A.), Head and Neck Surgery (W.M.C.K., C.L.Z.), Radiology (B.A.S.), and Molecular Oncology and Immunology (J.B.A.G.H.), Netherlands Cancer Institute, and the Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam (A.J.M.E.), Amsterdam, the Departments of Medical Oncology (C.U.B., J.B.A.G.H., F.M.S., E.K.) and Otorhinolaryngology Head and Neck Surgery (C.L.Z.), Leiden University Medical Center, Leiden, the Departments of Medical Oncology (K.A.T.N., R.C.S., A.A.M.V.), Surgical Oncology (D.J.G., R.C.S.), and Radiology and Nuclear Medicine (A.A.M.V.), Erasmus Medical Center, Rotterdam, the Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht (S.B.V., K.P.M.S.), the Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden (R.R.), the Department of Medical Oncology, Zuyderland Medical Center, Sittard-Geleen (F.W.P.J.B.), the Department of Medical Oncology, Medisch Spectrum Twente, Enschede (D.P.), the Department of Medical Oncology, Maxima Medical Center, Veldhoven (G.V.), the Department of Medical Oncology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht (M.J.B.A.), the Department of Medical Oncology, Amphia Hospital, Breda (M.A.M.S.B.), the Department of Medical Oncology, Radboud University Medical Center, Nijmegen (M.J.B.-S.), the Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen (G.A.P.H.), and Isala Oncology Center, Isala Hospital, Zwolle (J.-W.B.G.) - all in the Netherlands; the Department of Hematology and Medical Oncology, University Clinic Regensburg, Regensburg, Germany (C.U.B.); Melanoma Institute Australia (R.A.S., A.M.M., R.P.M.S., N.G.M., M.G., S.N.L., A.S., T.E.P., K.F.S., R.V.R., S.C., J.S., M.A.R., A.C.J.A., M.S.C., G.V.L.), the Faculty of Medicine and Health (R.A.S., A.M.M., R.P.M.S., N.G.M., S.N.L., A.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A., G.V.L.), and Charles Perkins Centre (R.A.S., G.V.L.), University of Sydney, the Departments of Tissue Pathology and Diagnostic Oncology (R.A.S., R.V.R.) and Melanoma and Surgical Oncology (R.P.M.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A.), Royal Prince Alfred Hospital, NSW Health Pathology (R.A.S., R.V.R.), the Departments of Medical Oncology (A.M.M., G.V.L.) and Breast and Melanoma Surgery (A.S.), Royal North Shore and Mater Hospitals, and the Department of Radiology, Mater Hospital (R.K.), Sydney, Royal Prince Alfred Hospital, Institute of Academic Surgery, Camperdown, NSW (A.C.J.A.), the Division of Cancer Surgery, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC (D.E.G.), the Department of Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC (L.S., S.S.), Lake Macquarie Oncology, Lake Macquarie Private Hospital, the Department of Medical Oncology, Calvary Mater Hospital, and the Department of Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW (A.W.), the Department of Medical Oncology, Princess Alexandra Hospital, University of Queensland, Brisbane (V.A.), the Department of Medical Oncology, Fiona Stanley Hospital, Perth, WA (M.K.), the Department of Medical Oncology, Alfred Health, Melbourne, and the Department of Medicine, School of Translational Medicine, Monash University, Melbourne, VIC (M.C.A.), and the Department of Medical Oncology, Westmead Hospital and Blacktown, Sydney (M.S.C.) - all in Australia; the Melanoma Clinic, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (J.B.A.G.H.); the Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland (J.P., P.R.); the Department of Medical Oncology, Centre Lon Brard, Lyon (M.A.-A.), Universit Paris Cit, Assistance Publique-Hpitaux de Paris (AP-HP) Dermato-Oncology and Clinical Investigation Center, Cancer Institute AP-HP, Nord Paris Cit, INSERM Unit 976, Saint Louis Hospital, Paris (C.L.), and the Department of Medical Oncology, Gustave Roussy and Paris-Saclay University, Villejuif (C.R.) - all in France; the Department of Surgical Oncology, Angeles Clinic and Research Institute, Los Angeles (M.B.F.); and the Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy (P.A.A.). (4) From the Departments of Medical Oncology (C.U.B., M.W.L., L.L.H., J.M.L., S.M.P., J.B.A.G.H., K.A.T.N., J.V.T., S.W., A.M.-E., I.L.M.R.), Pathology (B.A.W.), Biometrics (M.L.-Y., A.T.A., L.G.G.-O.), Surgical Oncology (W.J.H., A.M.J.K., A.C.J.A.), Head and Neck Surgery (W.M.C.K., C.L.Z.), Radiology (B.A.S.), and Molecular Oncology and Immunology (J.B.A.G.H.), Netherlands Cancer Institute, and the Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam (A.J.M.E.), Amsterdam, the Departments of Medical Oncology (C.U.B., J.B.A.G.H., F.M.S., E.K.) and Otorhinolaryngology Head and Neck Surgery (C.L.Z.), Leiden University Medical Center, Leiden, the Departments of Medical Oncology (K.A.T.N., R.C.S., A.A.M.V.), Surgical Oncology (D.J.G., R.C.S.), and Radiology and Nuclear Medicine (A.A.M.V.), Erasmus Medical Center, Rotterdam, the Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht (S.B.V., K.P.M.S.), the Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden (R.R.), the Department of Medical Oncology, Zuyderland Medical Center, Sittard-Geleen (F.W.P.J.B.), the Department of Medical Oncology, Medisch Spectrum Twente, Enschede (D.P.), the Department of Medical Oncology, Maxima Medical Center, Veldhoven (G.V.), the Department of Medical Oncology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht (M.J.B.A.), the Department of Medical Oncology, Amphia Hospital, Breda (M.A.M.S.B.), the Department of Medical Oncology, Radboud University Medical Center, Nijmegen (M.J.B.-S.), the Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen (G.A.P.H.), and Isala Oncology Center, Isala Hospital, Zwolle (J.-W.B.G.) - all in the Netherlands; the Department of Hematology and Medical Oncology, University Clinic Regensburg, Regensburg, Germany (C.U.B.); Melanoma Institute Australia (R.A.S., A.M.M., R.P.M.S., N.G.M., M.G., S.N.L., A.S., T.E.P., K.F.S., R.V.R., S.C., J.S., M.A.R., A.C.J.A., M.S.C., G.V.L.), the Faculty of Medicine and Health (R.A.S., A.M.M., R.P.M.S., N.G.M., S.N.L., A.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A., G.V.L.), and Charles Perkins Centre (R.A.S., G.V.L.), University of Sydney, the Departments of Tissue Pathology and Diagnostic Oncology (R.A.S., R.V.R.) and Melanoma and Surgical Oncology (R.P.M.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A.), Royal Prince Alfred Hospital, NSW Health Pathology (R.A.S., R.V.R.), the Departments of Medical Oncology (A.M.M., G.V.L.) and Breast and Melanoma Surgery (A.S.), Royal North Shore and Mater Hospitals, and the Department of Radiology, Mater Hospital (R.K.), Sydney, Royal Prince Alfred Hospital, Institute of Academic Surgery, Camperdown, NSW (A.C.J.A.), the Division of Cancer Surgery, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC (D.E.G.), the Department of Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC (L.S., S.S.), Lake Macquarie Oncology, Lake Macquarie Private Hospital, the Department of Medical Oncology, Calvary Mater Hospital, and the Department of Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW (A.W.), the Department of Medical Oncology, Princess Alexandra Hospital, University of Queensland, Brisbane (V.A.), the Department of Medical Oncology, Fiona Stanley Hospital, Perth, WA (M.K.), the Department of Medical Oncology, Alfred Health, Melbourne, and the Department of Medicine, School of Translational Medicine, Monash University, Melbourne, VIC (M.C.A.), and the Department of Medical Oncology, Westmead Hospital and Blacktown, Sydney (M.S.C.) - all in Australia; the Melanoma Clinic, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (J.B.A.G.H.); the Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland (J.P., P.R.); the Department of Medical Oncology, Centre Lon Brard, Lyon (M.A.-A.), Universit Paris Cit, Assistance Publique-Hpitaux de Paris (AP-HP) Dermato-Oncology and Clinical Investigation Center, Cancer Institute AP-HP, Nord Paris Cit, INSERM Unit 976, Saint Louis Hospital, Paris (C.L.), and the Department of Medical Oncology, Gustave Roussy and Paris-Saclay University, Villejuif (C.R.) - all in France; the Department of Surgical Oncology, Angeles Clinic and Research Institute, Los Angeles (M.B.F.); and the Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy (P.A.A.). (5) From the Departments of Medical Oncology (C.U.B., M.W.L., L.L.H., J.M.L., S.M.P., J.B.A.G.H., K.A.T.N., J.V.T., S.W., A.M.-E., I.L.M.R.), Pathology (B.A.W.), Biometrics (M.L.-Y., A.T.A., L.G.G.-O.), Surgical Oncology (W.J.H., A.M.J.K., A.C.J.A.), Head and Neck Surgery (W.M.C.K., C.L.Z.), Radiology (B.A.S.), and Molecular Oncology and Immunology (J.B.A.G.H.), Netherlands Cancer Institute, and the Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam (A.J.M.E.), Amsterdam, the Departments of Medical Oncology (C.U.B., J.B.A.G.H., F.M.S., E.K.) and Otorhinolaryngology Head and Neck Surgery (C.L.Z.), Leiden University Medical Center, Leiden, the Departments of Medical Oncology (K.A.T.N., R.C.S., A.A.M.V.), Surgical Oncology (D.J.G., R.C.S.), and Radiology and Nuclear Medicine (A.A.M.V.), Erasmus Medical Center, Rotterdam, the Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht (S.B.V., K.P.M.S.), the Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden (R.R.), the Department of Medical Oncology, Zuyderland Medical Center, Sittard-Geleen (F.W.P.J.B.), the Department of Medical Oncology, Medisch Spectrum Twente, Enschede (D.P.), the Department of Medical Oncology, Maxima Medical Center, Veldhoven (G.V.), the Department of Medical Oncology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht (M.J.B.A.), the Department of Medical Oncology, Amphia Hospital, Breda (M.A.M.S.B.), the Department of Medical Oncology, Radboud University Medical Center, Nijmegen (M.J.B.-S.), the Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen (G.A.P.H.), and Isala Oncology Center, Isala Hospital, Zwolle (J.-W.B.G.) - all in the Netherlands; the Department of Hematology and Medical Oncology, University Clinic Regensburg, Regensburg, Germany (C.U.B.); Melanoma Institute Australia (R.A.S., A.M.M., R.P.M.S., N.G.M., M.G., S.N.L., A.S., T.E.P., K.F.S., R.V.R., S.C., J.S., M.A.R., A.C.J.A., M.S.C., G.V.L.), the Faculty of Medicine and Health (R.A.S., A.M.M., R.P.M.S., N.G.M., S.N.L., A.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A., G.V.L.), and Charles Perkins Centre (R.A.S., G.V.L.), University of Sydney, the Departments of Tissue Pathology and Diagnostic Oncology (R.A.S., R.V.R.) and Melanoma and Surgical Oncology (R.P.M.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A.), Royal Prince Alfred Hospital, NSW Health Pathology (R.A.S., R.V.R.), the Departments of Medical Oncology (A.M.M., G.V.L.) and Breast and Melanoma Surgery (A.S.), Royal North Shore and Mater Hospitals, and the Department of Radiology, Mater Hospital (R.K.), Sydney, Royal Prince Alfred Hospital, Institute of Academic Surgery, Camperdown, NSW (A.C.J.A.), the Division of Cancer Surgery, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC (D.E.G.), the Department of Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC (L.S., S.S.), Lake Macquarie Oncology, Lake Macquarie Private Hospital, the Department of Medical Oncology, Calvary Mater Hospital, and the Department of Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW (A.W.), the Department of Medical Oncology, Princess Alexandra Hospital, University of Queensland, Brisbane (V.A.), the Department of Medical Oncology, Fiona Stanley Hospital, Perth, WA (M.K.), the Department of Medical Oncology, Alfred Health, Melbourne, and the Department of Medicine, School of Translational Medicine, Monash University, Melbourne, VIC (M.C.A.), and the Department of Medical Oncology, Westmead Hospital and Blacktown, Sydney (M.S.C.) - all in Australia; the Melanoma Clinic, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (J.B.A.G.H.); the Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland (J.P., P.R.); the Department of Medical Oncology, Centre Lon Brard, Lyon (M.A.-A.), Universit Paris Cit, Assistance Publique-Hpitaux de Paris (AP-HP) Dermato-Oncology and Clinical Investigation Center, Cancer Institute AP-HP, Nord Paris Cit, INSERM Unit 976, Saint Louis Hospital, Paris (C.L.), and the Department of Medical Oncology, Gustave Roussy and Paris-Saclay University, Villejuif (C.R.) - all in France; the Department of Surgical Oncology, Angeles Clinic and Research Institute, Los Angeles (M.B.F.); and the Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy (P.A.A.). (6) From the Departments of Medical Oncology (C.U.B., M.W.L., L.L.H., J.M.L., S.M.P., J.B.A.G.H., K.A.T.N., J.V.T., S.W., A.M.-E., I.L.M.R.), Pathology (B.A.W.), Biometrics (M.L.-Y., A.T.A., L.G.G.-O.), Surgical Oncology (W.J.H., A.M.J.K., A.C.J.A.), Head and Neck Surgery (W.M.C.K., C.L.Z.), Radiology (B.A.S.), and Molecular Oncology and Immunology (J.B.A.G.H.), Netherlands Cancer Institute, and the Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam (A.J.M.E.), Amsterdam, the Departments of Medical Oncology (C.U.B., J.B.A.G.H., F.M.S., E.K.) and Otorhinolaryngology Head and Neck Surgery (C.L.Z.), Leiden University Medical Center, Leiden, the Departments of Medical Oncology (K.A.T.N., R.C.S., A.A.M.V.), Surgical Oncology (D.J.G., R.C.S.), and Radiology and Nuclear Medicine (A.A.M.V.), Erasmus Medical Center, Rotterdam, the Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht (S.B.V., K.P.M.S.), the Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden (R.R.), the Department of Medical Oncology, Zuyderland Medical Center, Sittard-Geleen (F.W.P.J.B.), the Department of Medical Oncology, Medisch Spectrum Twente, Enschede (D.P.), the Department of Medical Oncology, Maxima Medical Center, Veldhoven (G.V.), the Department of Medical Oncology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht (M.J.B.A.), the Department of Medical Oncology, Amphia Hospital, Breda (M.A.M.S.B.), the Department of Medical Oncology, Radboud University Medical Center, Nijmegen (M.J.B.-S.), the Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen (G.A.P.H.), and Isala Oncology Center, Isala Hospital, Zwolle (J.-W.B.G.) - all in the Netherlands; the Department of Hematology and Medical Oncology, University Clinic Regensburg, Regensburg, Germany (C.U.B.); Melanoma Institute Australia (R.A.S., A.M.M., R.P.M.S., N.G.M., M.G., S.N.L., A.S., T.E.P., K.F.S., R.V.R., S.C., J.S., M.A.R., A.C.J.A., M.S.C., G.V.L.), the Faculty of Medicine and Health (R.A.S., A.M.M., R.P.M.S., N.G.M., S.N.L., A.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A., G.V.L.), and Charles Perkins Centre (R.A.S., G.V.L.), University of Sydney, the Departments of Tissue Pathology and Diagnostic Oncology (R.A.S., R.V.R.) and Melanoma and Surgical Oncology (R.P.M.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A.), Royal Prince Alfred Hospital, NSW Health Pathology (R.A.S., R.V.R.), the Departments of Medical Oncology (A.M.M., G.V.L.) and Breast and Melanoma Surgery (A.S.), Royal North Shore and Mater Hospitals, and the Department of Radiology, Mater Hospital (R.K.), Sydney, Royal Prince Alfred Hospital, Institute of Academic Surgery, Camperdown, NSW (A.C.J.A.), the Division of Cancer Surgery, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC (D.E.G.), the Department of Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC (L.S., S.S.), Lake Macquarie Oncology, Lake Macquarie Private Hospital, the Department of Medical Oncology, Calvary Mater Hospital, and the Department of Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW (A.W.), the Department of Medical Oncology, Princess Alexandra Hospital, University of Queensland, Brisbane (V.A.), the Department of Medical Oncology, Fiona Stanley Hospital, Perth, WA (M.K.), the Department of Medical Oncology, Alfred Health, Melbourne, and the Department of Medicine, School of Translational Medicine, Monash University, Melbourne, VIC (M.C.A.), and the Department of Medical Oncology, Westmead Hospital and Blacktown, Sydney (M.S.C.) - all in Australia; the Melanoma Clinic, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (J.B.A.G.H.); the Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland (J.P., P.R.); the Department of Medical Oncology, Centre Lon Brard, Lyon (M.A.-A.), Universit Paris Cit, Assistance Publique-Hpitaux de Paris (AP-HP) Dermato-Oncology and Clinical Investigation Center, Cancer Institute AP-HP, Nord Paris Cit, INSERM Unit 976, Saint Louis Hospital, Paris (C.L.), and the Department of Medical Oncology, Gustave Roussy and Paris-Saclay University, Villejuif (C.R.) - all in France; the Department of Surgical Oncology, Angeles Clinic and Research Institute, Los Angeles (M.B.F.); and the Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy (P.A.A.). (7) From the Departments of Medical Oncology (C.U.B., M.W.L., L.L.H., J.M.L., S.M.P., J.B.A.G.H., K.A.T.N., J.V.T., S.W., A.M.-E., I.L.M.R.), Pathology (B.A.W.), Biometrics (M.L.-Y., A.T.A., L.G.G.-O.), Surgical Oncology (W.J.H., A.M.J.K., A.C.J.A.), Head and Neck Surgery (W.M.C.K., C.L.Z.), Radiology (B.A.S.), and Molecular Oncology and Immunology (J.B.A.G.H.), Netherlands Cancer Institute, and the Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam (A.J.M.E.), Amsterdam, the Departments of Medical Oncology (C.U.B., J.B.A.G.H., F.M.S., E.K.) and Otorhinolaryngology Head and Neck Surgery (C.L.Z.), Leiden University Medical Center, Leiden, the Departments of Medical Oncology (K.A.T.N., R.C.S., A.A.M.V.), Surgical Oncology (D.J.G., R.C.S.), and Radiology and Nuclear Medicine (A.A.M.V.), Erasmus Medical Center, Rotterdam, the Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht (S.B.V., K.P.M.S.), the Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden (R.R.), the Department of Medical Oncology, Zuyderland Medical Center, Sittard-Geleen (F.W.P.J.B.), the Department of Medical Oncology, Medisch Spectrum Twente, Enschede (D.P.), the Department of Medical Oncology, Maxima Medical Center, Veldhoven (G.V.), the Department of Medical Oncology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht (M.J.B.A.), the Department of Medical Oncology, Amphia Hospital, Breda (M.A.M.S.B.), the Department of Medical Oncology, Radboud University Medical Center, Nijmegen (M.J.B.-S.), the Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen (G.A.P.H.), and Isala Oncology Center, Isala Hospital, Zwolle (J.-W.B.G.) - all in the Netherlands; the Department of Hematology and Medical Oncology, University Clinic Regensburg, Regensburg, Germany (C.U.B.); Melanoma Institute Australia (R.A.S., A.M.M., R.P.M.S., N.G.M., M.G., S.N.L., A.S., T.E.P., K.F.S., R.V.R., S.C., J.S., M.A.R., A.C.J.A., M.S.C., G.V.L.), the Faculty of Medicine and Health (R.A.S., A.M.M., R.P.M.S., N.G.M., S.N.L., A.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A., G.V.L.), and Charles Perkins Centre (R.A.S., G.V.L.), University of Sydney, the Departments of Tissue Pathology and Diagnostic Oncology (R.A.S., R.V.R.) and Melanoma and Surgical Oncology (R.P.M.S., T.E.P., K.F.S., S.C., J.S., M.A.R., A.C.J.A.), Royal Prince Alfred Hospital, NSW Health Pathology (R.A.S., R.V.R.), the Departments of Medical Oncology (A.M.M., G.V.L.) and Breast and Melanoma Surgery (A.S.), Royal North Shore and Mater Hospitals, and the Department of Radiology, Mater Hospital (R.K.), Sydney, Royal Prince Alfred Hospital, Institute of Academic Surgery, Camperdown, NSW (A.C.J.A.), the Division of Cancer Surgery, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC (D.E.G.), the Department of Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC (L.S., S.S.), Lake Macquarie Oncology, Lake Macquarie Private Hospital, the Department of Medical Oncology, Calvary Mater Hospital, and the Department of Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW (A.W.), the Department of Medical Oncology, Princess Alexandra Hospital, University of Queensland, Brisbane (V.A.), the Department of Medical Oncology, Fiona Stanley Hospital, Perth, WA (M.K.), the Department of Medical Oncology, Alfred Health, Melbourne, and the Department of Medicine, School of Translational Medicine, Monash University, Melbourne, VIC (M.C.A.), and the Department of Medical Oncology, Westmead Hospital and Blacktown, Sydney (M.S.C.) - all in Australia; the Melanoma Clinic, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (J.B.A.G.H.); the Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland (J.P., P.R.); the Department of Medical Oncology, Centre Lon Brard, Lyon (M.A.-A.), Universit Paris Cit, Assistance Publique-Hpitaux de Paris (AP-HP) Dermato-Oncology and Clinical Investigation Center, Cancer Institute AP-HP, Nord Paris Cit, INSERM Unit 976, Saint Louis Hospital, Paris (C.L.
