Risk of developing subsequent cutaneous malignant neoplasms with adjuvant pembrolizumab for stage IIB or IIC melanoma

Patients with melanoma are at risk of developing subsequent cutaneous malignant neoplasms. The effect of prior immunotherapy is unknown. Secondary analysis of the multinational phase 3 KEYNOTE-716 trial (adjuvant pembrolizumab versus placebo for stage IIB or IIC melanoma; n=976) found that the incidence of new primary melanoma was similar between participants treated with pembrolizumab and placebo, whereas nonmelanoma skin cancers were more common with placebo. Recurrence-free survival benefit associated with pembrolizumab remained after accounting for new primary melanomas. Immune-mediated severe skin reactions occurred infrequently and were manageable. The authors conclude that these data support the use of adjuvant pembrolizumab for high-risk stage II melanoma (visual abstract).