Surgical removal of the index node marked using magnetic seed localization to assess response to neoadjuvant immunotherapy in patients with stage III melanoma

doi:10.1002/bjs.11168

Randomized Controlled Trial

. 2019 Apr;106(5):519-522.

doi: 10.1002/bjs.11168. Epub 2019 Mar 18.

Surgical removal of the index node marked using magnetic seed localization to assess response to neoadjuvant immunotherapy in patients with stage III melanoma

B Schermers^{1

2}, V Franke¹, E A Rozeman³, B A van de Wiel⁴, A Bruining⁵, M W Wouters¹, W J van Houdt¹, B Ten Haken², S H Muller⁶, C Bierman⁴, T J M Ruers^{1

2}, C U Blank³, A C J van Akkooi¹

Affiliations

¹ Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
² MIRA Institute, University of Twente, Enschede, the Netherlands.
³ Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
⁴ Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
⁵ Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
⁶ Department of Clinical Physics, Netherlands Cancer Institute, Amsterdam, the Netherlands.

PMID: 30882901
PMCID: PMC6593699
DOI: 10.1002/bjs.11168

Randomized Controlled Trial

Surgical removal of the index node marked using magnetic seed localization to assess response to neoadjuvant immunotherapy in patients with stage III melanoma

B Schermers et al. Br J Surg. 2019 Apr.

. 2019 Apr;106(5):519-522.

doi: 10.1002/bjs.11168. Epub 2019 Mar 18.

Authors

Affiliations

¹ Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
² MIRA Institute, University of Twente, Enschede, the Netherlands.
³ Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
⁴ Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
⁵ Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
⁶ Department of Clinical Physics, Netherlands Cancer Institute, Amsterdam, the Netherlands.

PMID: 30882901
PMCID: PMC6593699
DOI: 10.1002/bjs.11168

Abstract

This pilot study explored the value of localized index node removal after neoadjuvant immunotherapy in patients with stage III melanoma, for use as a response indicator to guide the extent of completion lymph node dissection. Promising technology.

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Figures

**Figure 1**
Overview of the magnetic seed localization procedure a Proprietary magnetic seed on finger. b Correct positioning of the needle tip (red arrow) in lymph node (green arrow) before implantation. c Magnetic detector (Endomag Sentimag®) used during surgery to detect the seed. d Postoperative specimen X‐ray with magnetic seed (red arrow) *in situ*.

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References

1. Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 2009; 27: 6199–6206. - PMC - PubMed
1. Hodi FS, O'Day SJ, McDermott DF, Weber RW, Sosman JA, Haanen JB et al. Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med 2010; 363: 711–723. - PMC - PubMed
1. Postow MA, Chesney J, Pavlick AC, Robert C, Grossmann K, McDermott D et al. Nivolumab and ipilimumab versus ipilimumab in untreated melanoma. N Engl J Med 2015; 372: 2006–2017. - PMC - PubMed
1. Robert C, Schachter J, Long GV, Arance A, Grob JJ, Mortier L et al.; KEYNOTE-006 investigators. Pembrolizumab versus ipilimumab in advanced melanoma. N Engl J Med 2015; 372: 2521–2532. - PubMed
1. Blank CU, Rozeman EA, Fanchi LF, Sikorska K, van de Wiel B, Kvistborg P et al. Neoadjuvant versus adjuvant ipilimumab plus nivolumab in macroscopic stage III melanoma. Nat Med 2018; 24: 1655–1661. - PubMed

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[1] Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 2009; 27: 6199–6206. - PMC - PubMed

[2] Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 2009; 27: 6199–6206. - PMC - PubMed

[3] Hodi FS, O'Day SJ, McDermott DF, Weber RW, Sosman JA, Haanen JB et al. Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med 2010; 363: 711–723. - PMC - PubMed

[4] Hodi FS, O'Day SJ, McDermott DF, Weber RW, Sosman JA, Haanen JB et al. Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med 2010; 363: 711–723. - PMC - PubMed

[5] Postow MA, Chesney J, Pavlick AC, Robert C, Grossmann K, McDermott D et al. Nivolumab and ipilimumab versus ipilimumab in untreated melanoma. N Engl J Med 2015; 372: 2006–2017. - PMC - PubMed

[6] Postow MA, Chesney J, Pavlick AC, Robert C, Grossmann K, McDermott D et al. Nivolumab and ipilimumab versus ipilimumab in untreated melanoma. N Engl J Med 2015; 372: 2006–2017. - PMC - PubMed

[7] Robert C, Schachter J, Long GV, Arance A, Grob JJ, Mortier L et al.; KEYNOTE-006 investigators. Pembrolizumab versus ipilimumab in advanced melanoma. N Engl J Med 2015; 372: 2521–2532. - PubMed

[8] Robert C, Schachter J, Long GV, Arance A, Grob JJ, Mortier L et al.; KEYNOTE-006 investigators. Pembrolizumab versus ipilimumab in advanced melanoma. N Engl J Med 2015; 372: 2521–2532. - PubMed

[9] Blank CU, Rozeman EA, Fanchi LF, Sikorska K, van de Wiel B, Kvistborg P et al. Neoadjuvant versus adjuvant ipilimumab plus nivolumab in macroscopic stage III melanoma. Nat Med 2018; 24: 1655–1661. - PubMed

[10] Blank CU, Rozeman EA, Fanchi LF, Sikorska K, van de Wiel B, Kvistborg P et al. Neoadjuvant versus adjuvant ipilimumab plus nivolumab in macroscopic stage III melanoma. Nat Med 2018; 24: 1655–1661. - PubMed

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Surgical removal of the index node marked using magnetic seed localization to assess response to neoadjuvant immunotherapy in patients with stage III melanoma

Affiliations

Surgical removal of the index node marked using magnetic seed localization to assess response to neoadjuvant immunotherapy in patients with stage III melanoma

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