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.

The Following adjuvant therapies have been approved for funding in Canada:


British Columbia

BC has approved adjuvant nivolumab for stage III melanoma as of Nov 1 and indication is for every 2 or 4 weeks as per patient choice or physician recommendation
BC Cancer Patient Hand Out View Now
BC Cancer Protocol Summary

Ontario
Dabrafenib and Trametinib for Adjuvant Treatment of Stage III BRAF-Mutated, Fully Resected Melanoma.  The effective date is January 7, 2020. This is for BRAF positive patients and provides up to 12 months coverage.

Cancer Care Ontario New Drug Funding Program effective January 29, 2020 – for Nivolumab – Adjuvant treatment for completely resected stage III or IV melanoma

Quebec
View press release “now reimbursed in Quebec for adjuvant melanoma patients with BRAF V600 mutation and lymph node involvement”

The following adjuvant therapies are being considered in Canada:

nivolumab (Opdivo) has received a final positive recommendation from pCODR, (the pan-Canadian Oncology Drug Review), and INESSS, subject to price negotiations between provinces and the manufacturer.Individuals with private insurance may have access now. For individuals without private insurance, the manufacturer is providing interim compassionate access – please check with your oncology team for details. 

Individuals with private insurance may have access now. For individuals without private insurance, the manufacturer is providing interim compassionate access – please check with your oncology team for details. 

View the CADTH pan-Canadian Oncology Drug Review Details:

dabrafenib (Tafinlar) + trametinib (Mekinist) a positive recommendation from pCODR, (the pan-Canadian Oncology Drug Review), for the adjuvant treatment of patients with stage IIIA (limited to lymph node metastases of > 1 mm) to stage IIID (8th edition of the American Joint Committee on Cancer [AJCC] staging system) BRAF-mutated (all BRAF V600 mutations) cutaneous melanoma. Price negotiations between provinces and the manufacturer are still pending the final recommendation.

View the CADTH pan-Canadian Oncology Drug Review Details:

View press release “now reimbursed in Quebec for adjuvant melanoma patients with BRAF V600 mutation and lymph node involvement”

pembrolizumab (Keytruda) waiting for recommendations for adjuvant use.

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

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