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Malignant Melanoma
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Five to seven percent of melanoma patients have a strong family history. Many of these patients have familial atypical multiple mole melanoma syndrome previously referred to as dysplastic nevus syndrome characterized by a large number of atypical melanocytic nevi and mutations in the tumor suppressor gene CDKN2A which is critical in cell cycle regulation. Mutations in CDKN2A are associated with a 50–90% risk of melanoma by age 80 years.
Cutaneous malignant melanoma: epidemiology, endocrine features and hormone replacement therapy
Published in A. R. Genazzani, Hormone Replacement Therapy and Cancer, 2020
Patients with the dysplastic nevus syndrome who were pregnant or taking oral contraceptives or sex steroid hormone supplements were studied prospectively to evaluate the effectiveness of close follow-up in detecting nevus changes of melanoma development33. The rate of nevi change observed clinically was 3.9 times higher when patients were pregnant than when they were not, whereas no differences were observed whether or not women took exogenous hormones. Whereas some case reports have suggested that pregnancy could exacerbate the activity of this malignancy, five controlled studies showed that patients who were diagnosed with melanoma during pregnancy had the same survival as that of control women of childbearing age who were not pregnant at the time of diagnosis34–38. Two studies found that a prior pregnancy had no effect on the clinical outcome of patients with melanoma38,39. A better prognosis has, however, been reported in cases of five or more prior pregnancies. Furthermore, Reintgen and colleagues34 and MacKie and co-workers38 detected no difference in survival between women who become pregnant after diagnosis of melanoma and appropriate controls.
A Probabilistic Neural Network Framework for the Detection of Malignant Melanoma
Published in Raouf N.G. Naguib, Gajanan V. Sherbet, Artificial Neural Networks in Cancer Diagnosis, Prognosis, and Patient Management, 2001
M. Hintz-Madsen, L.K. Hansen, J. Larsen, K.T. Drzewiecki
Due to the rather steep increase in the number of reported malignant melanoma cases, it is becoming increasingly important to develop simple, objective and preferably non-invasive methods that are capable of diagnosing malignant melanoma. Today, the only accurate diagnostic technique is a biopsy and a histological analysis of the skin tissue sample. This is an expensive procedure as well as an uncomfortable experience for the patient. For patients with many skin lesions or dysplastic nevus syndrome (patients with dysplastic nevus syndrome have multiple dysplastic nevi – often in the dozens or even hundreds), this is clearly not a feasible diagnostic technique. The problem is further complicated due to the increasing awareness of skin cancer among the general population. People are consulting dermatologists more often, which again calls for a simple and accurate diagnostic technique.
Characterization of uveal melanoma clinical trial design: a systematic review to establish an elusive standard of care
Published in Acta Oncologica, 2020
Harrison G. Zhang, Justin C. Moser, Lauren A. Dalvin
Uveal melanoma is a molecularly and clinically unique cancer which arises from melanocytes of the uveal tract, including the iris, ciliary body, and choroid [1]. It is the most common primary intraocular malignancy in adults, affecting approximately 5.1 in 1 million people [2]. Risk factors for uveal melanoma include light eye color, fair skin, ocular melanocytosis, dysplastic nevus syndrome, residence in northern latitudes, and germline BRCA1-associated protein 1 (BAP1) mutations [3–7]. Although the incidence rate of uveal melanoma in the United States has remained stagnant since the 1970s and there have been numerous advances in other areas of medical oncology globally, outcomes for uveal melanoma patients have not substantially improved [2]. About 50% of patients will develop uveal melanoma metastasis, most commonly to the liver, and about 45% of patients die from systemic metastases within 15 years [8]. Meta-analyses have estimated median overall survival (OS) for patients with metastatic disease to be only 10 to 13 months, and a meta-analysis of published survival outcomes found no association between OS and the decade of publication [8–12]. Currently, there is no US Food and Drug Administration (FDA) or European Medicines Agency (EMA)-approved standard of care for patients diagnosed with metastatic uveal melanoma. Thus, there is a critical need for clinical trials to investigate treatments that will improve survival and finally establish a standard of care. Herein, we perform a systematic review of registered clinical trials for uveal melanoma on the ClinicalTrials.gov database and European Union (EU) Clinical Trials Register in order to rigorously assess the current landscape of clinical trials associated with this disease and identify potential areas for improvement for future trials. We examine sources of funding, intervention methods, general design characteristics, primary outcome measures with respect to an interventional trial’s purpose, and characteristics of negative randomized trials.
Cutaneous eyelid melanoma in an African American child
Published in Orbit, 2021
Jan P. Ulloa-Padilla, Armen Khararjian, Catherine J. Choi
Most cases of CM in children develop from pre-existing lesions such as congenital or acquired nevi.2 While the etiology is likely multifactorial, p53, CDKN2A, CDK4, BAP1, POT1, ACD, TERF2IP, TERT, BRCA2, MC1 R mutations, as well as conditions such as dysplastic nevus syndrome and xeroderma pigmentosum have been linked to greater risk of developing melanoma.3