Adjuvant Therapy
ADJUVANT THERAPIES
Early melanoma that has not spread beyond the skin or nearby lymph nodes is usually treated with surgery. Adjuvant therapy is additional cancer treatment given after the primary treatment (surgery), to lower the risk that the cancer will come back. Stage III patients that have had surgery and are considered to have no further evidence of disease (fully resected), still may be at higher risk for recurrence of melanoma.
Adjuvant therapy or clinical trials are typically offered to stage III patients after they have had a complete surgical resection of their melanoma. Please consult with your medical team to determine current treatments or clinical trials available for stage III patients.
Adjuvant Therapies in Melanoma –
A guide to navigate treatment options
Download your FREE patient guide for Adjuvant Therapy from Melanoma Network of Canada.
English – Download
French – Download
Types of Adjuvant Therapy Treatments
Nivolumab (Opdivo) This is an immune checkpoint inhibitor that targets PD-1, a protein on immune system cells (called T cells) that normally help keep these cells from attacking other cells in the body. By blocking PD-1, this drug boosts the immune response against melanoma cells. This can often shrink tumours and help people live longer. Learn more about immunotherapies.
Dabrafenib (Tafinlar) + trametinib (Mekinist) help prevent melanoma that has a certain type of abnormal “BRAF” gene from coming back after the cancer has been removed by surgery. Dabrafenib acts as an inhibitor of the BRAF protein and slows down or stops the growth of cancer cells while trametinib acts against the MEK protein. Both BRAF and MEK are key molecules that help regulate cell growth. A BRAF mutation signals cells, via MEK, to develop abnormally and divide out of control and grow into a melanoma tumour. Learn more about targeted therapies.
Pembrolizumab (Keytruda) This drug is an immune checkpoint inhibitor that targets PD-1, a protein on immune system cells (called T cells), that normally helps keep these cells from attacking other cells in the body. By blocking PD-1, this drug boosts the immune response against melanoma cells. This can often shrink tumours and help people live longer. Learn more about immunotherapies.
The Following adjuvant therapies have been approved for funding in Canada:
Alberta
AB has approved the following adjuvant treatments. Please click on the links for full criteria information
Dabrafenib & Trametinib (Tafinlar & Mekinist)
Nivolumab (Opdivo)
Pembrolizumab (Keytruda)
British Columbia
BC has approved the following adjuvant treatments. Please click on the links for full criteria information
Dabrafenib & Trametinib (Tafinlar & Mekinist)
Nivolumab (Opdivo)
Pembrolizumab (Keytruda)
Helpful links:
BC Cancer Patient Hand Out View Now
BC Cancer Protocol Summary
Manitoba
MB has approved the following adjuvant treatments. Please click on the links for full criteria information
Dabrafenib & Trametinib (Tafinlar & Mekinist)
Nivolumab (Opdivo)
Pembrolizumab (Keytruda)
New Brunswick
NB has approved the following adjuvant treatments. Please click on the links for full criteria information
Dabrafenib & Trametinib (Tafinlar & Mekinist)
Nivolumab (Opdivo)
Pembrolizumab (Keytruda)
Helpful links
New Brunswick Drug Plan Criteria PDF
New Brunswick Drug Plans Formulary Updates Website
Newfoundland
NL has approved the following adjuvant treatments. Please click on the links for full criteria information
Dabrafenib & Trametinib (Tafinlar & Mekinist)
Pembrolizumab (Keytruda)
Nova Scotia
NS has approved the following adjuvant treatments. Please click on the links for full criteria information
Dabrafenib & Trametinib (Tafinlar & Mekinist)
Nivolumab (Opdivo)
Pembrolizumab (Keytruda)
Helpful Links:
https://novascotia.ca/dhw/pharmacare/pharmacists_bulletins/Pharmacists_Bulletin_April_20-04.pdf
Ontario
ON has approved the following adjuvant treatments. Please click on the links for full criteria information
Dabrafenib & Trametinib (Tafinlar & Mekinist)
Nivolumab (Opdivo)
Pembrolizumab (Keytruda)
Under provincial consideration
Quebec INESSS
Dabrafenib (Tafinlar) + trametinib (Mekinist) is now listed under the Quebec public drug insurance plan to prevent recurrence of melanoma (adjuvant therapy) following surgery for eligible melanoma patients with the BRAF V600 mutationii. The combination use of the two Novartis cancer therapies as targeted treatment will be reimbursed for patients who meet specific criteria.
View press release “now reimbursed in Quebec for adjuvant melanoma patients with BRAF V600 mutation and lymph node involvement”
Pembrolizumab (Keytruda) In monotherapy, for the adjuvant treatment of melanoma with regional lymph nodes, in people:
- melanoma must be completely resected; And
- last resection was in the previous 13 weeks; And
- performance status according to the ECOG is 0 or 1
The maximum duration of each authorization is 4 months. When requesting further treatment, the physician will have to provide proof of a beneficial clinical effect by the absence of recurrence of the disease. The maximum duration of treatment is 12 months
Saskatchewan
SK has approved the following adjuvant treatments. Please click on the links for full criteria information
Dabrafenib & Trametinib (Tafinlar & Mekinist)
Nivolumab (Opdivo)
Pembrolizumab (Keytruda)
Yukon
Please note that the Yukon follows the BC Cancer Drug Benefit List /Systemic Therapy Program guidelines for treatment and utilizes the CAP process, however do their own contracting and have a separate, unique reimbursement system.
YK has approved the following adjuvant treatments. Please click on the links for full criteria information
Dabrafenib & Trametinib (Tafinlar & Mekinist)
Nivolumab (Opdivo)
Pembrolizumab (Keytruda)
More details can be found on the below links:
Use Protocol:
http://www.bccancer.bc.ca/chemotherapy-protocols-site/Documents/Melanoma/USMAJDT_Protocol.pdf
Preprinted Order:
http://www.bccancer.bc.ca/chemotherapy-protocols-site/Documents/Melanoma/USMAJDT_PPPO.pdf
Patient Handout:
http://www.bccancer.bc.ca/chemotherapy-protocols-site/Documents/Melanoma/USMAJDT_Handout.pdf
Article: Considerations for Adjuvant Therapy
If you or a loved one is considering adjuvant treatments here are some questions to consider.
Adjuvant Therapy Update
The latest informaiton on adjuvant therapies, presented live in Hamilton by Dr. Elaine McWhirter MD, MSc., FRCPC, Medical Oncologist, Juravinski Cancer Centre
Subscribe
Sign up to receive the latest news from Melanoma Network of Canada