Current prospects of successful therapeutic procedures in advanced stage melanoma – the short review
Keywordsmelanoma, naevus, ultraviolet radiation, molecular target treatment, immunotherapy,
Introduction and purpose: Melanoma is the most aggressive form of skin cancer with a rapid course of disease in advanced stage according to the melanoma staging system of the American Joint Committee on Cancer (AJCC). Its morbidity has increased from 20th century. Intermittent sun exposure, age and skin phenotype are included into main risk factors of melanoma. The gold standard in diagnostic and therapeutic procedures is the naevus excisional biopsy associated with histopathology examination. The knowledge about immune system and melanoma biology have enabled therapeutic advantages, such as immunotherapy and molecular target therapy.
Objective: To review currently available data on PubMed about current prospects of successful therapeutic procedures in advanced stage melanoma.
A brief description of the state of knowledge: A systemic complementary therapy and non-specific immunotherapy are used for treatment advanced-stage-melanoma patients. Current knowledge has enabled an implementation of molecular target therapy in advanced stage melanoma. Evidence based science has yielded promising results and it has included these therapies to the clinical practice, especially molecular target therapy and immunotherapy as well. BRAF inhibitors including vemurafenib, dabrafenib and MEK inhibitors including trametinib are considered to medicaments, that have molecular mechanism of action. Nivolumab, pembrolizumab, ipilimumab are examples of monoclonal antibodies, which are used as an immunotherapy.
Conclusions: Excisional biopsy associated with histopathology have been an essential element in therapeutic and diagnostic procedures. Current achievements of medicine sciences have shed light on biology and pathogenesis highlighting the role of immunotherapy and molecular target treatment as well.
MacKie RM, Hauschild A, Eggermont AM: Epidemiology of invasive cutaneous melanoma. Ann Oncol 20: 1-7, 2009.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, in press. The online GLOBOCAN 2018 database is accessible at http://gco.iarc.fr/, as part of IARC’s Global Cancer Observatory
Joanna Didkowska et al.; Cancer in Poland 2017; Polish National Cancer Registry Department of Epidemiology and Cancer Prevention;
Rutkowski P, Wysocki PJ, Nasierowska-Guttmejer A et al. Cutaneous melanomas. Oncol Clin Pract 2019; 15.
Gilchrest BA, Eller MS, Geller AC, Yaar M. The pathogenesis of melanoma induced by ultraviolet radiation. N Engl J Med. 1999; 340:1341–1348.
Leonardi, G. C., Falzone, L., Salemi, R., Zanghì, A., Spandidos, D. A., Mccubrey, J. A., Candido, S., & Libra, M. (2018). Cutaneous melanoma: From pathogenesis to therapy (Review). International journal of oncology, 52(4), 1071–1080.
Gilchrest BA, Eller MS, Geller AC, Yaar M, The pathogenesis of melanoma induced by ultraviolet radiation. N Engl J Med. 1999 Apr 29; 340(17):1341-8.
Bevona C, Goggins W, Quinn T, Fullerton J, Tsao H. Cutaneous melanomas associated with nevi. Arch Dermatol. 2003; 139:1620–1624.
Gershenwald, Jeffrey E et al. “Melanoma staging: Evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual.” CA: a cancer journal for clinicians vol. 67,6 (2017): 472-492.
Korn EL, Liu PY, Lee SJ, et al. Meta-analysis of phase II cooperative group trials in metastatic stage IV melanoma to determine progression-free and overall survival benchmarks for future phase II trials. J Clin Oncol. 2008;26(4):527-534.
Chappell WH et al.; Ras/Raf/MEK/ERK and PI3K/PTEN/Akt/mTOR inhibitors: rationale and importance to inhibiting these pathways in human health.; Oncotarget. 2011 Mar; 2(3):135-64.
Cohen C et al. Mitogen-actived protein kinase activation is an early event in melanoma progression; Clin Cancer Res. 2002 Dec; 8(12):3728-33
Curtin JA, Fridlyand J, Kageshita T, et al. Distinct sets of genetic alterations in melanoma. N Engl J Med. 2005;353(20):2135-2147.
Chapman PB, Hauschild A, Robert C, et al. BRIM-3 Study Group. Improved survival with vemurafenib in melanoma with BRAF V600E mutation. N Engl J Med. 2011; 364(26): 2507–2516
Long GV, Stroyakovskiy D, Gogas H, Levchenko E, de Braud F, Larkin J, Garbe C, Jouary T, Hauschild A, Grob JJ, et al. Dabrafenib and trametinib versus dabrafenib and placebo for Val600 BRAF-mutant melanoma: A multicentre, double-blind, phase 3 randomised controlled trial. Lancet. 2015; 386: 444–451.
The Nobel Prize in Physiology or Medicine 2018. NobelPrize.org. Nobel Media AB 2020. Mon. 18 May 2020.
Passarelli A, Mannavola F, Stucci LS, Tucci M, Silvestris F. Immune system and melanoma biology: a balance between immunosurveillance and immune escape. Oncotarget. 2017;8(62):106132‐106142. Published 2017 Oct 31.
Zhu X, Lang J. J Gynecol Oncol. 2017;28(5):e64.
Kee D, McArthur G. Immunotherapy of melanoma. Eur J Surg Oncol. 2017;43(3):594-603.
Senzer NN, Kaufman HL, Amatruda T, et al. Phase II clinical trial of a granulocyte-macrophage colony-stimulating factor-encoding, second-generation oncolytic herpesvirus in patients with unresectable metastatic melanoma. J Clin Oncol. 2009;27(34):5763-5771.
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