Melanoma Management最新文献

{"title":"Primary cilia: putting a sensor on the underlying melanocytic tumor cell state.","authors":"Ursula E Lang","doi":"10.2217/mmt-2020-0008","DOIUrl":"https://doi.org/10.2217/mmt-2020-0008","url":null,"abstract":"Melanocytic neoplasms constitute some of the most challenging histopathologic entities in pathology and trigger high levels of diagnostic uncertainty among general practice pathologists and even among expert dermatopathologists [1,2]. When histopathologic findings are ambiguous or indeterminate, one turns to immunohistochemical and/or genetic analyses, given sufficient tissue and resources [3]. These additional tests can provide valuable information about the underlying genetic drivers, level of genomic instability and relative levels of key transcripts, which are then integrated with histopathology and clinical information [4]. When fortunate enough to obtain the genetic data, the hope is for a compelling basis to definitively classify the tumor. Analysis may be less than straightforward, as mutations or chromosomal changes of unknown significance may be uncovered. Additional impediments to diagnosis include poor quality DNA, low purity of tumor cells and a chromosomal copy-number neutral melanoma. For these reasons, the gold standard remains histopathologic review by an experienced dermatopathologist. Often the true malignant potential remains a mystery, and management is aimed at balancing caution with morbidity. In such instances, one can wonder if microRNA (miRNA), transcriptomic or DNA methylation data would shed more light onto the underlying biologic potential [5–7]. In the case of miRNAs, which are stable in formalin-fixed paraffin-embedded (FFPE) tissue, several studies have shown the potential for use as diagnostic biomarkers [6,8]. Although mRNA is less stable than miRNAs in FFPE, commercially available kits leverage a limited panel of gene transcripts that can predict risk of recurrence, metastasis and assist in diagnosis [9]. DNA methylation shares the advantage of stability similar to miRNAs, and appears to correlate with poor prognosis in advanced melanoma [5]. The epigenetic information gained from methylation analysis remains unknown in histopathologically indeterminate lesions. Challenges in using these tests include the lack of high-quality evidence guiding best practice use [10]. As any cell biologist will attest, it is the proteome and interactome of cells that ultimately results in behavior. While the complexity can be overwhelming, it remains a fascination and continues to propel the field of melanoma biology. It is in this vein that the assessment of primary cilia has emerged as a window into melanoma cell biology. The primary cilium is ubiquitous cell surface organelle that acts as cellular antenna, sensing the extracellular environment and transmitting downstream signals [11]. Many important signaling pathways have been linked to the primary cilium in a cell-context-dependent manner and implicated in cancer pathogenesis [12]. With respect to melanocytes and melanoma progression, there are limited but intriguing data to support the WNT/β-catenin pathway being repressed by an intact primary cilium [13]. Additionally, the ","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"7 2","pages":"MMT40"},"PeriodicalIF":3.6,"publicationDate":"2020-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2020-0008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38294800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparity in outcomes of melanoma adjuvant immunotherapy by demographic profile.","authors":"Alexandra Ikeguchi,&nbsp;Michael Machiorlatti,&nbsp;Sara K Vesely","doi":"10.2217/mmt-2020-0002","DOIUrl":"https://doi.org/10.2217/mmt-2020-0002","url":null,"abstract":"<p><strong>Background: </strong>Randomized comparisons have demonstrated survival benefit of adjuvant immunotherapy in node-positive melanoma patients but have limited power to determine if this benefit persists across various demographic factors.</p><p><strong>Materials & methods: </strong>We assessed the impact of demographic factors on the survival benefit of adjuvant immunotherapy in a database of 38,189 node-positive melanoma patients using the Kaplan-Meier method and Cox proportional hazards models.</p><p><strong>Results: </strong>All assessed demographic factors other than race significantly impacted survival of node-positive melanoma patients in univariate analysis. In multivariable analysis, only the age group interacted with immunotherapy.</p><p><strong>Conclusion: </strong>Analysis of this large database of unselected node-positive melanoma patients demonstrated a positive survival benefit of immunotherapy across all demographic factors assessed and the impact was greater for patients 65 years of age and older.</p>","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"7 2","pages":"MMT43"},"PeriodicalIF":3.6,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2020-0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38286648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational study of talimogene laherparepvec use in the anti-PD-1 era for melanoma in the US (COSMUS-2).","authors":"James Sun, Brian R Gastman, Lucy McCahon, Elizabeth I Buchbinder, Igor Puzanov, Michele Nanni, James M Lewis, Richard D Carvajal, Shahnaz Singh-Kandah, Anupam M Desai, Leon Raskin, Carrie M Nielson, Rubina Ismail, Jonathan S Zager","doi":"10.2217/mmt-2020-0005","DOIUrl":"10.2217/mmt-2020-0005","url":null,"abstract":"<p><strong>Aim: </strong>Talimogene laherparepvec (T-VEC) is an intralesional therapy for unresectable, metastatic melanoma. T-VEC real-world use in the context of anti-PD1-based therapy requires further characterization.</p><p><strong>Materials & methods: </strong>A retrospective review of T-VEC use from 1 January 2017 and 31 March 2018 for melanoma patients was conducted at seven US institutions.</p><p><strong>Results: </strong>Among 83 patients, three categories of T-VEC and anti-PD-1 therapy were identified: T-VEC used without anti-PD-1 (n = 29, 35%), T-VEC after anti-PD-1-based therapy (n = 22, 27%) and concurrent T-VEC and anti-PD-1-based therapy (n = 32, 39%). 25% of patients discontinued T-VEC therapy due to no remaining injectable lesions, 37% discontinued T-VEC due to progressive disease. Discontinuation of T-VEC did not differ by anti-PD-1-based therapy use or timing.</p><p><strong>Conclusion: </strong>In real-world settings, T-VEC may be used concurrently with or after anti-PD-1-based therapy.</p>","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"7 2","pages":"MMT41"},"PeriodicalIF":3.6,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/5e/mmt-07-41.PMC7426742.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38294801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melanoma brain metastases: review of histopathological features and immune-molecular aspects.","authors":"Lorenzo Salvati,&nbsp;Mario Mandalà,&nbsp;Daniela Massi","doi":"10.2217/mmt-2019-0021","DOIUrl":"https://doi.org/10.2217/mmt-2019-0021","url":null,"abstract":"<p><p>Patients with melanoma brain metastases (MBM) have a dismal prognosis, but the unprecedented advances in systemic therapy alone or in combination with local therapy have now extended the 1-year overall survival rate from 20-25% to nearing 80-85%, mainly in asymptomatic patients. The histopathological and molecular characterization of MBM and the understanding of the microenvironment are critical to more effectively manage patients with advanced melanoma and to design biologically driven clinical trials. This review aims to give an overview of the main histopathological features and the immune-molecular aspects of MBM.</p>","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"7 2","pages":"MMT44"},"PeriodicalIF":3.6,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2019-0021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38286649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Welcome to volume 7 of <i>Melanoma Management</i>.","authors":"Caitlin Killen","doi":"10.2217/mmt-2020-0003","DOIUrl":"https://doi.org/10.2217/mmt-2020-0003","url":null,"abstract":"","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"7 1","pages":"MMT34"},"PeriodicalIF":3.6,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2020-0003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37927040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increase of sentinel lymph node melanoma staging in The Netherlands; still room and need for further improvement.","authors":"Eric A Deckers,&nbsp;Marieke Wj Louwman,&nbsp;Schelto Kruijff,&nbsp;Harald J Hoekstra","doi":"10.2217/mmt-2019-0018","DOIUrl":"https://doi.org/10.2217/mmt-2019-0018","url":null,"abstract":"<p><strong>Aim: </strong>To investigate implementation of the seventh American Joint Committee on Cancer melanoma staging with sentinel lymph node biopsy (SLNB) and associations with socioeconomic status (SES).</p><p><strong>Patients & methods: </strong>Data from The Netherlands Cancer Registry on patient and tumor characteristics were analyzed for all stage IB-II melanoma cases diagnosed 2010-2016, along with SES data from The Netherlands Institute for Social Research.</p><p><strong>Results: </strong>The proportion of SLNB-staged patients increased from 40% to 65% (p < 0.001). Multivariate analysis showed that being female, elderly, or having head-and-neck disease reduced the likelihood of SLNB staging.</p><p><strong>Conclusion: </strong>SLNB staging increased by 25% during the study period but lagged among elderly patients and those with head-and-neck melanoma. In The Netherlands, SES no longer affects SLNB staging performance.</p>","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"7 1","pages":"MMT38"},"PeriodicalIF":3.6,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2019-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37927045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and survival outcomes in stages II and III cutaneous melanoma: a systematic review.","authors":"Rachael Miller,&nbsp;Sophie Walker,&nbsp;Irene Shui,&nbsp;Agnes Brandtmüller,&nbsp;Kevin Cadwell,&nbsp;Emilie Scherrer","doi":"10.2217/mmt-2019-0022","DOIUrl":"https://doi.org/10.2217/mmt-2019-0022","url":null,"abstract":"<p><strong>Aim: </strong>Management of cutaneous melanoma (CM) is continually evolving with adjuvant treatment of earlier stage disease. The aim of this review was to identify published epidemiological data for stages II-III CM.</p><p><strong>Materials & methods: </strong>Systematic searches of Medline and Embase were conducted to identify literature reporting country/region-specific incidence, prevalence, survival or mortality outcomes in stage II and/or III CM. Screening was carried out by two independent reviewers.</p><p><strong>Results & conclusion: </strong>Of 41 publications, 14 described incidence outcomes (incidence rates per stage were only reported for US and Swedish studies), 33 reported survival or mortality outcomes and none reported prevalence data. This review summarizes relevant data from published literature and highlights an overall paucity of epidemiological data in stages II and III CM.</p>","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"7 1","pages":"MMT39"},"PeriodicalIF":3.6,"publicationDate":"2020-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2019-0022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37927046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetics plays a role in nevi distribution in women.","authors":"Alessia Visconti, Marianna Sanna, Veronique Bataille, Mario Falchi","doi":"10.2217/mmt-2019-0019","DOIUrl":"10.2217/mmt-2019-0019","url":null,"abstract":"","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"7 1","pages":"MMT35"},"PeriodicalIF":3.6,"publicationDate":"2020-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/42/mmt-07-35.PMC7212503.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37927042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective evaluation of risk-appropriate management of uveal melanoma patients informed by gene expression profiling.","authors":"Amy C Schefler,&nbsp;Alison Skalet,&nbsp;Scott Cn Oliver,&nbsp;John Mason,&nbsp;Anthony B Daniels,&nbsp;Katherina M Alsina,&nbsp;Kristen M Plasseraud,&nbsp;Federico A Monzon,&nbsp;Brian Firestone","doi":"10.2217/mmt-2020-0001","DOIUrl":"https://doi.org/10.2217/mmt-2020-0001","url":null,"abstract":"Aim: The Clinical Application of DecisionDx-UM Gene Expression Assay Results study aimed to evaluate the clinical utility of the prognostic 15-gene expression profile (15-GEP) test for uveal melanoma (UM) patients in a large, prospective multicenter cohort. Patients & methods: Nine centers prospectively enrolled 138 UM patients clinically tested with the 15-GEP. Physician-recommended specialty referrals and metastatic surveillance regimens were collected. Results: A total of 93% of high-risk class 2 patients were referred to medical oncology for follow-up, compared with 51% of class 1 patients. A majority (62%) of class 2 patients were recommended overall high-intensity metastatic surveillance, while 85% of class 1 patients were recommended low-intensity metastatic surveillance. Conclusion: Treatment plan recommendations for UM patients are aligned with GEP-informed metastatic risk, consistent with prior studies.","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"7 1","pages":"MMT37"},"PeriodicalIF":3.6,"publicationDate":"2020-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2020-0001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37927044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durability of response in metastatic melanoma patients after combined treatment with radiation therapy and ipilimumab.","authors":"Quaovi H Sodji, Paulina M Gutkin, Susan M Swetter, Sunil A Reddy, Susan M Hiniker, Susan J Knox","doi":"10.2217/mmt-2019-0020","DOIUrl":"10.2217/mmt-2019-0020","url":null,"abstract":"<p><strong>Aim: </strong>We previously reported a prospective trial evaluating the safety and efficacy of combining ipilimumab and radiation therapy in patients with metastatic melanoma. Herein, we provide a long-term update on patients with complete response (CR) or partial response (PR).</p><p><strong>Patients & methods: </strong>We continued to follow these patients with serial imaging including computed tomography, PET or MRI.</p><p><strong>Results: </strong>Two of the three patients with CR are still alive and without evidence of melanoma but with chronic treatment-induced hypophysitis. The third patient died of hepatocellular carcinoma, but with no evidence of melanoma. Among the three patients with PR, two achieved CR after pembrolizumab monotherapy.</p><p><strong>Conclusion: </strong>This long-term follow up reveals the striking durability of the CRs, which appears to correlate with a grade 2-3 hypophysitis.</p>","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"7 1","pages":"MMT36"},"PeriodicalIF":3.6,"publicationDate":"2020-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/bd/mmt-07-36.PMC7212514.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37927043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}