What surveillance plan would you recommend for stage IV melanoma patients who achieve a CR or stable PR response with immunotherapy?

If melanoma patients have achieved CR or PR after a year of immunotherapy treatment, I highly recommend participation in this ongoing ECOG cooperative study: EA6192 / PET-Stop Educational Materials - ECOG-ACRIN Cancer Research Group (NCT04462406).

The study uses PET scans in combination with contrasted scans at the end of 52 +/- 2 weeks of treatment, to help determine whether patients still have any metabolically active residual disease. If not, they will go on surveillance (q3 months for the first post-treatment year, q4 mo the second year, q6 months afterwards, per NCCN melanoma surveillance guideline). If they have FDG-avid lesions above mediastinal blood-pool, the lesions will have to be biopsied to determine whether they would go on surveillance vs another year of treatment. The main reason for this study being done is that there is no data on the optimal duration of immunotherapy treatment, and there are increased risks of irAEs with prolonged immunotherapy treatment (i.e. type 1 diabetes, organ damage such as endocrinopathies, etc.).