A 47-year-old man underwent wide excision and completion lymph node dissection for a 3.2 mm ulcerated melanoma with one positive regional node, and imaging shows no distant disease. Which adjuvant therapy has shown improved relapse-free survival in resected stage III melanoma?

• A Intralesional Bacillus Calmette-Guerin vaccine
• B Topical 5-fluorouracil to the surgical scar
• C Oral acitretin
• D Adjuvant anti-PD-1 antibody such as nivolumab or pembrolizumab ✓

Explanation

For completely resected stage III melanoma, adjuvant anti-PD-1 therapy (nivolumab or pembrolizumab) significantly improves relapse-free survival compared with placebo or ipilimumab, and is current standard of care. Older options such as interferon alfa have largely been replaced. Topical agents and intralesional BCG have no role as adjuvant systemic therapy in this setting.

Reference: Abeloff's Clinical Oncology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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