Hayley Hetherington rarely thought about melanoma after she had one removed from the back of her scalp in 2019.
Life got busy. She started a new job, her father was sick back home in the UK and COVID was making everything from travel to medical checkups a small nightmare.
Professor Georgina Long, co-medical director of the Melanoma Institute Australia, and Hayley Hetherington, a teacher from Fairlight who participated in the worldwide trial.Credit: Edwina Pickles
In July 2022, during a six-monthly skin check, she asked her doctor about a lump on the back of her head. A biopsy confirmed the cancer had reappeared and spread to her lymph nodes. She was diagnosed with stage three melanoma.
“It was very scary, and worrying,” she said. “It just takes one or two little melanoma cells to escape the original thing and that’s it.”
Hetherington was referred to Professor Georgina Long, the Melanoma Institute Australia’s co-medical director, who put her on a phase three clinical trial testing the efficacy of immune therapy given before, rather than after, surgery.
Results from the trial, published on Sunday in the New England Journal of Medicine, showed a significant decrease in the rate of cancer progression before surgery, recurrence after surgery and death in stage three melanoma patients who had neoadjuvant (pre-surgery) immunotherapy, when compared with patients who received the conventional treatment post-surgery.
The groundbreaking study sets the stage for pre-surgery immunotherapy to become the global standard approach to combating melanoma, and lays the groundwork for new treatments to fight other cancers, said Professor Christian Blank, a pioneering immunotherapy researcher at the Netherlands Cancer Institute who co-led the international trial alongside Long.
“By using combination checkpoint inhibitor immunotherapy before rather than after surgery, we now have the clinical proof needed to change treatment protocols,” said Blank, who will present the findings at the American Society of Clinical Oncology conference in Chicago this week.
One-third of the 423 patients were Australian. Of the 212 patients randomised into the neoadjuvant arm of the trial, 83.7 per cent made it to 12 months “event-free”, compared to 57.2 per cent in the control cohort (in clinical trials, an “event” occurs if the cancer progresses before surgery, reoccurs after surgery, or if the participant dies).