Melanoma

Published by Andy LoCascio at July 6, 2018

Melanoma

November, 2022 DREAMSeq Trial Clarifies Treatment Sequencing in BRAF V600–Mutant Melanoma
https://www.onclive.com/view/dreamseq-trial-clarifies-treatment-sequencing-in-braf-v600-mutant-melanoma

November, 2022 Investigators Highlight Top Advances at ESMO 2022-Melanoma
Neoadjuvant versus adjuvant pembrolizumab for resected stage III-IV melanoma
https://www.onclive.com/view/investigators-highlight-top-advances-at-esmo-2022

November, 2022 Clinically Meaningful and Durable Activity in Largest Cell Therapy Clinical Trial in Patients with Melanoma After Progression on Immune Checkpoint Inhibitors
https://www.bakersfield.com/ap/news/iovance-biotherapeutics-announces-updated-clinical-data-for-lifileucel-in-advanced-melanoma-at/article_7b4d9090-2647-5d14-91b2-bf975e43e6bd.html

October, 2022 IMC-F106C Shows Potential as T-cell Receptor–Driven Therapy in Melanoma
https://www.onclive.com/view/imc-f106c-shows-potential-as-t-cell-receptor-driven-therapy-in-melanoma

October, 2022 Encorafenib/Binimetinib Delivers Prolonged Survival in BRAF V600–Mutant Melanoma
https://www.onclive.com/view/encorafenib-binimetinib-delivers-prolonged-survival-in-braf-v600-mutant-melanoma

October, 2022 Adjuvant Nivolumab Reduces Risk of Recurrence or Death by 58% in Select Stage IIB or IIC Melanoma
https://www.onclive.com/view/adjuvant-nivolumab-reduces-risk-of-recurrence-or-death-by-58-in-select-stage-iib-or-iic-melanoma

Overview of Melanoma

Melanoma is a cancer that starts in the melanocyte (melanin producing) cells of the skin. Melanoma begins when normal melanocytes change and grow uncontrollably, forming a tumor. Melanoma most often starts on the chest or back.

Melanoma is less common than basal cell and squamous cell skin cancers (accounting for less than 5% of skin cancers) but it is usually far more dangerous and likely to spread to other parts of the body. When found early, melanoma can often be cured with surgery. However, melanoma is the most serious form of skin cancer and can grow deep into the skin, invading lymph and blood vessels.

Treatment is more difficult when the melanoma has spread to other organs, and involves shrinking the skin cancer through a combination of surgery, chemotherapy, radiation and immunotherapy treatments.

Treatments for Melanoma

Treatment of Melanoma depends on how far the tumor has grown within the skin, whether the cancer has spread to nearby lymph nodes and whether the cancer has metastasized to distant organs. Based on the stage of melanoma, treatment options may include: surgery, immunotherapy, targeted therapy, chemotherapy, and radiation therapy.

Stage I: in Stage I, melanoma is treated by wide excision where a 1-2 cm incision is made around the original melanoma site. A sentinel lymph node biopsy (following the path of an injected radioactive tracer substance and dye injected into the melanoma) may also be performed to ascertain if the melanoma has spread to the nearest lymph nodes. If the sentinel lymph node biopsy is positive it is usually followed by a lymph node dissection, sometimes with interferon immunology treatment.

Stage II: in Stage II, the standard treatment is a wide excision, sentinel lymph node biopsy (if positive, followed by a lymph node dissection), interferon treatment and/ or vaccines.

Stage III: in Stage III, treatment includes a wide excision surgery and lymph node dissection. Adjuvant therapy with interferon immunotherapy and radiation therapy to the areas where the lymph nodes were removed may be recommended. Immunotherapy treatments to stimulate the immune system may be used which may include the Bacille Calmette-Guerin (BCG) vaccine, interluekin-2, and imiquimod cream. Chemotherapy may be combined with immunotherapy. For melanomas on an arm or leg, isolated limb perfusion may be , using a heated solution of chemotherapy to the limb).

Stage IV: in Stage IV, treatment includes surgery, radiation therapy, immunotherapy, targeted therapy and/or chemotherapy. There are many types of immunotherapy used for advanced melanoma by boosting the immune system to better attack the cancer, such as Ipilimumab (Yervoy) and pembrolizumab (Keytruda), which are both versions of a type of immune system protein (monoclonal antibodies).

Drugs targeting specific gene changes: in about 50% of melanomas, the cancer cells have mutations in the BRAF gene and treatments that target this change may be used, including vemurafenib, dabrafenib, and trametinib.

For melanomas with mutations in the C-KIT gene, imatinib and nilotinib may be prescribed. Chemotherapy, such as dacarbazine or temozolomide, may be used in a biochemotherapy treatment plan using interleukin-2, interferon, or both.

Clinical Trials for Melanoma

Melanoma research Foundation Clinical Trials
http://www.melanoma.org/understand-melanoma/melanoma-treatment/clinical-trials

National Cancer Institute Melanoma Trials
http://www.cancer.gov/clinicaltrials/results/type/melanoma

Center Watch Metastatic Melanoma Clinical Trial
http://www.cancertrialshelp.org/aboutus_content/aboutusMainContent.aspx?intAppMode=12

Center Watch Clinical Trials
https://www.centerwatch.com/clinical-trials/listings/condition/723/metastatic-melanoma

Eviti Clinical Trial Source
https://www.eviticlinicaltrials.com/cancertrialshelp/membership.aspx?memid=66757

Additional Educational Resources for Melanoma

Skin Cancer Foundation Melanoma Information
http://www.skincancer.org/skin-cancer-information/melanoma

Cancer.net
http://www.cancer.net/cancer-types/melanoma

Patient Advocacy Foundation: Melanoma & Skin Cancer Resources
http://www.patientadvocate.org/index.php?p=827

Medicine.net
http://www.medicinenet.com/melanoma/article.htm

American Cancer Society: Melanoma
http://www.cancer.org/espanol/index

Melanoma Research Foundation
http://www.melanoma.org/