Based on the results of SWOG S1801, neoadjuvant vs adjuvant pembrolizumab for resected stage IIIB-IV melanoma, are you starting to recommend neoadjuvant pembro for your patients?

Yes, I now usually would recommend neoadjuvant therapy for melanoma stage 3.

If a clinical trial is open, I prefer to enroll patients in it.

Patients who have contraindications to immunotherapy are treated with surgery first.

I agree with the above recommendations. If there is a clinical trial for neo-adjuvant therapy, that would be favored. Outside of a clinical trial, neo-adj pembrolizumab is a reasonable approach for this group of patients.