How do you approach patients with very low risk stage IIIA cutaneous melanoma for adjuvant immunotherapy?  

Very-low-risk stage IIIA disease includes non-ulcerated lesions, primary ≤2 mm thickness, SLN metastasis <1 mm. Per NCCN the toxicity of adjuvant therapy may outweigh the benefit. However, recent studies have shown benefit in stage IIB,IIC with adjuvant pembrolizumab. Can we extrapolate the results to this group? 

Answer from: Medical Oncologist at Academic Institution
Medical Oncologist at Meritus Hematology & Oncology Specialists
Thank you for your input. Very helpful. 
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