Initial Treatment
All patients received WLE in accordance with the National Comprehensive
Cancer Network (NCCN) surgical management of melanoma guidelines. Of the
nineteen patients who underwent a sentinel lymph node biopsy (SLNB) at
the time of WLE, 11 had a positive SLN (57.9%). Of these 19 patients, 6
received nivolumab, 1 received interferon alpha-2b, and 1 received
tremelimumab within 90 days of the WLE. Out of the three patients with
ulceration, two received nivolumab. Eighteen patients were considered in
complete remission (CR) following their initial treatment. Two patients
had recurrence of their melanoma (at 10 and 19 months from WLE) and 2
other patients were still undergoing initial nivolumab treatment at the
time of the writing of this article. The patients (n=6) whose initial
therapy included nivolumab in addition to WLE did not show recurrence or
progression of their disease. Out of the 6 patients who received
nivolumab therapy, 4 had no adverse events (66.7%), 1 had a grade 3
lichenoid drug eruption (leading to treatment discontinuation) and 1 had
peripheral eosinophilia (prompting treatment withholding for 1 month).