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Watch Beach Adventure 6 Milftoon Videos on Letmejerk.com, the biggest free porn tube site . Beach. Milftoon Beach Adventure 6 2013 > DOWNLOAD (Mirror. MCA cohort, only 3.3% of the patients had stable disease, and 18.3% had progressive disease.^[@R14]^ Therefore, it is conceivable that conventional CTLA-4 blockade in the adjuvant setting could improve adjuvant immune response. In fact, up-regulation of CTLA-4 expression on antigen-specific T cells and enhancement of T-cell function was observed during an active immunotherapy response following CTLA-4 blockade.^[@R8]^

Adjuvant CTLA-4 blockade is a new and attractive strategy to prevent tumor recurrence and progression. There are multiple ways to administer this strategy. A first possibility would be to target the effector phase of the immune system using a monoclonal antibody. This modality is being extensively studied in metastatic disease^[@R20]^ and will be evaluated in adjuvant trials to prevent recurrence. Another possibility is the use of immune checkpoint inhibitors such as ipilimumab. While ipilimumab has demonstrated impressive and durable responses in melanoma, additional evaluations in other tumors are needed.^[@R21]^

CONCLUSIONS {#s4}
===========

In summary, adjuvant CTLA-4 blockade is a viable option to prevent recurrence or progression in patients with melanoma who have been surgically resected with a macroscopic negative margin. In the current study, adjuvant CTLA-4 blockade was demonstrated to be associated with prolonged recurrence-free survival in patients with microscopic melanoma at risk for recurrence. These findings should stimulate further studies to identify better biomarkers of early recurrence as well as predictive markers of response to CTLA-4 blockade. Patients with advanced melanoma have already shown successful responses to CTLA-4 blockade.^[@R22]^ Adjuvant CTLA-4 blockade should be considered for this population.

Conflict of interest statement {#s5}
==============================

The authors have no conflict of interest to declare.

Supplementary Material
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