Melanoma Management最新文献

{"title":"An update on the relevance of vaccine research for the treatment of metastatic melanoma.","authors":"Robert O Dillman","doi":"10.2217/mmt-2017-0021","DOIUrl":"10.2217/mmt-2017-0021","url":null,"abstract":"<p><p>Signal transduction inhibitors and anticheckpoint antibodies have significantly improved survival for metastatic melanoma patients, but most still die within 5 years. Vaccine approaches to induce immunity to well-characterized melanoma-associated antigens, or to antigens expressed on allogeneic tumor cell lines, have not resulted in approved agents. Despite the limitations associated with the immunosuppressive tumor microenvironment, there now is one intralesional autologous vaccine approved for patients who have primarily soft-tissue metastases. There is continued interest in patient-specific vaccines, especially dendritic cell vaccines that utilize <i>ex vivo</i> loading of autologous antigen, thus bypassing certain <i>in vivo</i> immunosuppressive cells and cytokines. Because of their mechanism of action and limited toxicity, they are potentially synergistic or additive to other antimelanoma therapies.</p>","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"4 4","pages":"203-215"},"PeriodicalIF":3.6,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2017-0021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36471133","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":"Has the melanoma information tsunami become a maelstrom?","authors":"John F Thompson, Alexander M Menzies","doi":"10.2217/mmt-2017-0020","DOIUrl":"10.2217/mmt-2017-0020","url":null,"abstract":"","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"4 4","pages":"179-182"},"PeriodicalIF":3.6,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6094604/pdf/mmt-04-179.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36471131","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":"Management of the cutaneous adverse effects of antimelanoma therapy.","authors":"Rose Congwei Liu,&nbsp;Germana Consuegra,&nbsp;Pablo Fernández-Peñas","doi":"10.2217/mmt-2017-0015","DOIUrl":"https://doi.org/10.2217/mmt-2017-0015","url":null,"abstract":"The advent of targeted therapy and immunotherapy has revolutionized the management of advanced melanoma. However, these novel therapies are associated with adverse effects (AEs), of which cutaneous toxicities are the most frequently observed. These cutaneous AEs can exert significant morbidity and impact on patient quality of life, hence the recognition and management of AEs is fundamental in preventing interruption or cessation of survival-prolonging treatments. Additionally, knowledge of these AEs are necessary in order for healthcare professionals to counsel patients when starting treatment and in the initiation of AE prophylaxis. The incidence and clinical presentation of the cutaneous toxicities of novel melanoma therapies will be discussed, and treatment guidelines provided.","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"4 4","pages":"187-202"},"PeriodicalIF":3.6,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2017-0015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36471132","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":"Prognostic molecular testing in melanoma: ready for prime time?","authors":"Jennifer Keller,&nbsp;Laurence P Diggs,&nbsp;Eddy C Hsueh","doi":"10.2217/mmt-2017-0013","DOIUrl":"https://doi.org/10.2217/mmt-2017-0013","url":null,"abstract":"","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"4 4","pages":"171-174"},"PeriodicalIF":3.6,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2017-0013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36470686","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":"Anti-PD-1 and PD-L1 antibodies in metastatic melanoma.","authors":"Ester Simeone,&nbsp;Paolo A Ascierto","doi":"10.2217/mmt-2017-0018","DOIUrl":"https://doi.org/10.2217/mmt-2017-0018","url":null,"abstract":"“ Genetic mutations and dysregulation of the immune system may be related in some patients and may have an important impact on the efficacy of therapies. ” The advent of monoclonal antibodies that target CTLA-4 (ipilimumab) or PD-1 checkpoints (nivolumab and pembrolizumab) has increased hopes of improved outcomes in advanced melanoma. However, resistance remains an important issue. Genetic mutations and dysregulation of the immune system may be related in some patients and may have an important impact on the efficacy of therapies. Another explanation may be that patients who progressed in the chemotherapy arm may then have received pembrolizumab. In the CheckMate 066 study in patients with previously untreated BRAF wild-type advanced melanoma, ORR was also higher with first-line nivolumab compared with chemotherapy (dacarbazine; 40 vs 13.9%) [3] . Median OS of patients treated with nivolumab was not reached [4] . The other approved anti-PD-1, pembrolizumab, has shown a similar benefit as nivolumab. The Phase I KEYNOTE 001 study showed a median OS of 20 months for all studied doses and was 28 months in ipilimumab-naive patients. Similar results were seen at 3 years [5] . The Phase II KEYNOTE 002 study showed the benefit of pembrolizumab compared with chemotherapy in patients previously treated with ipilimumab and a BRAF or MEK inhibitor, with an ORR of 22.2 and 27.6% for pembrolizumab 2 and 10 mg / kg, respectively, compared with 4.5% with chemotherapy. Median progression-free survival (PFS) at 2 years was significantly prolonged with pembrolizumab at both doses, but median OS was only significantly improved in patients treated with pembrolizumab 10 mg / kg (14.7 vs. 11 months with chemotherapy; p = 0.01; hazard ratio = 0.74) [6] . In the KEYNOTE 006 Phase III trial, first- or second-line pembrolizumab in BRAF mutant or wild-type melanoma patients had a higher response rate compared with ipilimumab. OS at 2 years with pembrolizumab was 55 versus 43% with ipilimumab [7] . At median follow-up of nearly 3 years, 33-month OS and PFS rates with pembrolizumab compared with ipilimumab were 50 versus 39% and 31 versus 14%, respectively [8] . Moreover, responses were durable in 104 patients who stopped pembrolizumab treatment after 2 years as per the study protocol; at a median follow-up of at 9.7 months after completing 2 years of","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"4 4","pages":"175-178"},"PeriodicalIF":3.6,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2017-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36470687","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":"COMBATING NRAS MUTANT MELANOMA: FROM BENCH TO BEDSIDE.","authors":"Ileabett M Echevarría-Vargas,&nbsp;Jessie Villanueva","doi":"10.2217/mmt-2017-0023","DOIUrl":"https://doi.org/10.2217/mmt-2017-0023","url":null,"abstract":"“ Oncogenic NRAS plays a critical role in melanoma initiation and maintenance; however, to date there are no effective ways to directly block the activity of mutant NRAS. ” NRAS is the second most common oncogenic driver in melanoma, mutated predominantly at codon 61 in almost 30% of all melanomas [1] . Tumors bearing NRAS mutations are highly aggressive and are associated with shorter patient survival [2] . Despite the prevalence of NRAS mutations and the severity of the resulting disease, treatment for NRAS mutant melanoma has lagged far behind BRAF-mutant tumors. Here, we summarize the status of the most promising strategies, highlighting the successes and the gaps that remain to be filled. GTP guanine-nucleotide exchange mutant form of to GAPs, leading to NRAS activation and persistent signaling that triggers and","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"4 4","pages":"183-186"},"PeriodicalIF":3.6,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2017-0023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36118032","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":"Immune checkpoint inhibitors in the treatment of advanced mucosal melanoma.","authors":"James C Kuo","doi":"10.2217/mmt-2017-0014","DOIUrl":"https://doi.org/10.2217/mmt-2017-0014","url":null,"abstract":"<p><p>Immunotherapy with immune checkpoint inhibitors is the standard of care in the treatment of advanced melanoma. Treatment outcome of these agents is less defined for the rare subtype of mucosal melanoma. In this single-institutional case series, the objective response rate was low at 11.8%, but durable response was seen, including a complete response to first-line ipilimumab and to second-line pembrolizumab. Survival remained poor; at the median follow-up of 10.1 months, the median progression-free survival and overall survival were 3.1 and 8.8 months respectively. Nevertheless, among the few responders, survival of up to 56+ months was observed. Other treatment strategies need to be explored to improve treatment outcome for this rare subtype.</p>","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"4 3","pages":"161-167"},"PeriodicalIF":3.6,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2017-0014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36470685","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":"Anti-PD-1 monotherapy versus anti-PD1 plus anti-CTLA4 in advanced melanoma: how do we decide?","authors":"Lewis Au,&nbsp;Aine O'Reilly,&nbsp;James Larkin","doi":"10.2217/mmt-2017-0016","DOIUrl":"https://doi.org/10.2217/mmt-2017-0016","url":null,"abstract":"","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"4 3","pages":"151-155"},"PeriodicalIF":3.6,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2017-0016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36468077","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":"Advantages of whole-genome sequencing for identification of tumor etiology and clinically actionable genomic aberrations: lessons from the Australian Melanoma Genome Project.","authors":"James S Wilmott,&nbsp;Nicholas K Hayward,&nbsp;Graham J Mann,&nbsp;Richard A Scolyer","doi":"10.2217/mmt-2017-0008","DOIUrl":"https://doi.org/10.2217/mmt-2017-0008","url":null,"abstract":"","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"4 3","pages":"147-149"},"PeriodicalIF":3.6,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2017-0008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36468076","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":"Can we improve melanoma detection methods?","authors":"Riccardo Pampena,&nbsp;Caterina Longo","doi":"10.2217/mmt-2017-0009","DOIUrl":"https://doi.org/10.2217/mmt-2017-0009","url":null,"abstract":"","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":"4 3","pages":"139-142"},"PeriodicalIF":3.6,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/mmt-2017-0009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36468073","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}