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metastatic melanoma

Friday 7 December 2012

metastasis of a melanoma; metastatic malignant melanoma

Digital cases

- JRC:111 : Metastatic malignant melanoma in a lymph node.
- JRC:3168 : Metastatic malignant melanoma in the ovary.
- JRC:14087 : Pulmonary metastasis of a melanoma.
- JRC:14614 : Metastatic malignant melanoma (vs primary CNS-type melanoma vs malignant epithelioid schwannoma).
- Malignant Melanoma, Liver FNA by Ed Euthman

Images

-  metastatic melanoma involving the gallbladder mucosa

Treatment

The survival of advanced metastatic melanoma has been greatly improved by targeted therapy, like kinase inhibitors for BRAF-mutant melanoma, and immune checkpoint blockers.

In a review, thirty-five Kaplan–Meier survival curves from 17 trials were digitised, re-grouped by matching inclusion criteria and treatment line, and averaged by therapy strategy. Notably, the survival curves grouped by therapy strategy revealed a very high concordance, even if different agents were used. (26707829)

The greatest survival improvement was observed with the combination of BRAF inhibitors plus MEK inhibitors as well as with Programmed-death-1 (PD1) blockers with or without cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) blockers, respectively, with these two treatment strategies showing similar survival outcomes. (26707829)

For first-line therapy, averaged survival proportions of patients alive at 12 months were 74.5% with BRAF plus MEK inhibitor treatment versus 71.9% with PD-1 blockade. This explorative comparison shows the kinase inhibitors as similarly effective as immune checkpoint blockers with regard to survival. (26707829)

See also

- malignant melanoma

References

- Survival of patients with advanced metastatic melanoma: The impact of novel therapies. Ugurel S, Röhmel J, Ascierto PA, Flaherty KT, Grob JJ, Hauschild A, Larkin J, Long GV, Lorigan P, McArthur GA, Ribas A, Robert C, Schadendorf D, Garbe C. Eur J Cancer. 2016 Jan;53:125-34. doi : 10.1016/j.ejca.2015.09.013 PMID: 26707829