Tag Archive | "melanoma"

What Surveillance Testing Should Be Done After Melanoma Diagnosis?

Source: Medical Research, June 2018

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The optimal surveillance strategy to detect recurrence in cutaneous melanoma remains elusive. Risk of recurrence increases with higher stage, and is especially high for patients with stage IIIC disease. Although consensus guidelines agree on surveillance imaging for high-risk (stage IIB-IIIC) MEL, there is no consensus regarding optimal frequency/modality in these patients. NCCN guidelines suggest chest radiography (CXR) at 6- to 12-month intervals for stage IA-IIA melanoma  patients; although this is controversial. There exists a great deal of practice variation in the surveillance of these patients.

MedicalResearch.com: What should readers take away from your report?

Response: The incidence of pulmonary and extra-pulmonary metastases increases with stage. CXR reliably detects pulmonary metastases in patients with stage I-III melanoma.

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Immunotherapy for Metastatic Melanoma – In the Clinic

Source: Cancer Therapy Advisor, March 2018

Staging melanoma requires consideration of multiple factors: thickness, ulceration status, the number of involved lymph nodes, and the presence of metastases.1

Patients with stage II or worse disease are more likely to develop metastases in their lifetime. While the primary treatment for melanoma is surgical excision, patients with metastatic disease require additional therapy; immunotherapy is an innovative class of medications accumulating data for use in this patient-group.

In melanoma, the immune response plays a crucial role via CTLA-4 and PD-1. CTLA-4 is a regulator of the body’s activated immune system response to cancer cells and down-regulates T cell activation.2 Ipilimumab is an anti-CTLA-4 monoclonal antibody designed to stimulate the immune system’s response to melanoma by bolstering T cell activation.

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Expert Discusses Role of Mutation Status in Treatment Decisions for Melanoma

Source: Targeted Oncology, March 2018

Although there are several single- and dual-agent treatment options available for patients diagnosed with melanoma who harbor a BRAF mutation, therapeutic options for patients with non-BRAF melanoma are still limited.

There are potential combination strategies, including MEK and ERK inhibitors, under investigation for patients with NRAS-mutant tumors, which make up about 20% to 25% of the melanoma patient population, says Ryan J. Sullivan, MD. However, the activity that has been seen with these options is only in the 15% to 20% range, compared with the above 50% response rates seen in early trials of BRAF inhibitors.

In an interview with Targeted Oncology, Sullivan, assistant professor, medicine, Harvard Medical School, and assistant professor, Hematology/Oncology, Massachusetts General Hospital, discussed the available therapies for patients with BRAF-mutant and non-BRAF-mutant melanoma, as well as the current role of mutation status in treatment decision making.

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Obesity Associated With Improved Melanoma Outcomes

Source: Cancer Therapy Advisor, March 2018

Being of obese body mass index (BMI) is associated with better outcomes among patients with metastatic melanoma treated with targeted or immunotherapy, according to a retrospective study published in Lancet Oncology.1

Jennifer L. McQuade, MD, MA, of The University of Texas MD Anderson Cancer Center in Houston, Texas, and lead author of the study, noted that the results were surprising. “We hypothesized that obesity would be associated with worse outcomes in patients with metastatic melanoma treated with immunotherapy and targeted therapy.”

Though multiple studies indicate that higher BMI is associated with an increased risk of developing or dying from different cancer subtypes, some observational studies suggest that overweight BMI may have a protective effect during cancer treatment.2 Morbid obesity, however, has been associated with poor outcomes. This phenomenon is referred to as the obesity paradox.

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