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Melanoma
Published in Debjani Sahni, Adam Lerner, Bilal Fawaz, Advanced Skin Cancer, 2022
Until recently, treatment of metastatic melanoma was mostly palliative with chemotherapy and/or radiation. Since 2011, the approval of several targeted therapies and immune checkpoint inhibitors has revolutionized the field of melanoma therapeutics and significantly improved the survival of metastatic melanoma patients.13 Agents used for targeted therapy include BRAF inhibitors (e.g., dabrafenib) and MEK inhibitors (e.g., trametinib). Immune checkpoint inhibitor therapeutic agents include cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) inhibitors (e.g., ipilimumab) and programmed cell death 1 (PD-1) inhibitors (e.g., pembrolizumab).4 Other recently approved modalities include Talimogene Laherparepvec (T-VEC), which is a modified oncolytic herpes simplex virus type 1 (HSV-1) having the capacity to express granulocyte macrophage colony-stimulating factor (GM-CSF). T-VEC is approved as intralesional therapy for use in inoperable metastases that are accessible to injection.13,14
The Precision Medicine Approach in Oncology
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
A study evaluated this assay for its value in supporting the use of pembrolizumab (KeytrudaTM) in patients. This human monoclonal antibody targets the Programmed Cell Death 1 (PD-1) receptor of lymphocytes, and was approved by the FDA in 2017 for the treatment of metastatic melanoma, and any unresectable or metastatic solid tumors with certain genetic anomalies (e.g., mismatch repair deficiency or microsatellite instability). This was the first time that the FDA had approved an anticancer agent based on tumor genetics rather than tissue type or tumor site.
Malignant Melanoma
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Patients with metastatic melanoma have a poor prognosis and until recently systemic treatment was largely ineffective. This has changed dramatically with the development of targeted agents and new immune regulating monoclonal antibodies. In patients of stage IV disease, defining the mutational status of the tumor (BRAF, c-KIT, and NRAS) is key to planning management. Surgery and radiotherapy offer palliation in certain circumstances, for example, radiotherapy for bone and brain metastases and surgery for other metastases.
Impact of Aluminium phthalocyanine nanoconjugate on melanoma stem cells
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2023
Bridgette Mkhobongo, Rahul Chandran, Heidi Abrahamse
Metastatic melanoma has a poor prognosis, particularly in patients whose disease has advanced to visceral metastases, with statistics indicating a median survival rate of only a few months [1]. Melanoma was the third most frequent disease diagnosed worldwide in Australia in 2020, according to the Global Cancer Observatory. As a result, South Africa ranks just 16th globally in terms of melanoma incidence rates, behind Australia and New Zealand. In South Africa, in 2020, there were 1777 new cases of melanoma of the skin reported, affecting people of all ages and genders with 480 deaths. South Africa was rated 22nd in the world in terms of mortality rate in 2020 [2]. Men are more likely than women to be diagnosed with melanoma. Men have a 1 in 13 probability of developing melanoma by the age of 85, while women have a 1 in 21 probabilities. The anticipated number of new instances in Africa for both sexes and ages 0 to 85 years has increased from 6963 to 13650 from 2020 to 2040 [2].
Nivolumab + relatlimab for the treatment of unresectable or metastatic melanoma
Published in Expert Opinion on Biological Therapy, 2023
Hanna Koseła-Paterczyk, Piotr Rutkowski
2a. What are the unmet needs of currently available therapies? Once a patient is diagnosed with metastatic melanoma there is two possible options of treatment targeted therapy (in case of BRAF mutant melanoma, that account of about half of the patients) and immunotherapy (available regardless of the BRAF status). BRAF/MEK inhibitor treatment results in high rates of response to treatment with PFS around one year, and OS exceeding two years, but with majority of patients experiencing disease progression during the therapy. Immunotherapy on the other hand, in case of monotherapy results with lower rates of response to therapy but prolonged survival in the responding patients. Combination immunotherapy with nivolumab and ipilimumab combines benefits of both aforementioned treatment with high response rates and long survival, but with a price of very high treatment toxicity rates [6].
Radiation therapy and immunotherapy in breast cancer treatment: preliminary data and perspectives
Published in Expert Review of Anticancer Therapy, 2021
Kim Cao, Louisa Abbassi, Emanuela Romano, Youlia Kirova
The successful development of new modalities of immunotherapy, particularly immune checkpoint inhibitors (ICIs), has highlighted the role of the immune system in the fight against cancer, as host-antitumor immunity is able to recognize and eliminate tumor cells. The underlying biological mechanisms are now becoming more clearly understood. Radiotherapy is an old anticancer treatment, used for its local effects. Until recently, the systemic effects of radiotherapy have been limited to the rarely demonstrated abscopal effect defined by Mole in 1953 [1]. Its role in cancer immunity has been better understood as a result of the growth of immunotherapy. Several recent studies have raised the efficacy of the combined use of immunotherapy and radiotherapy, in locally advanced non-small-cell lung cancer (NSCLC) [2] and metastatic melanoma [3]. Breast cancers, considered, as a whole, to be poorly immunogenic tumors, should be assessed based on hormone-receptor and HER-2 status.