Updates in the Management of Uveal Melanoma
Cancer J. 2024 Mar-Apr 01;30(2):92-101. doi: 10.1097/PPO.0000000000000708.ABSTRACTUveal melanoma (UM), arising from intraocular melanocytes, poses a complex clinical challenge with a substantial risk of distant metastasis, often to the liver. Molecular profiling, encompassing genetic, cytogenetic, gene expression, and immunological subsets, plays a pivotal role in determining prognoses. The evolving landscape includes promising systemic treatments, such as tebentafusp, a novel immune-modulating bispecific fusion protein, and targeted therapies. Combined regional and systemic approaches, including immune checkpoint inhibito...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Mali Barbi Richard D Carvajal Craig E Devoe Source Type: research
Local and Systemic Management Options for Melanoma Brain Metastases
Cancer J. 2024 Mar-Apr 01;30(2):102-107. doi: 10.1097/PPO.0000000000000711.ABSTRACTDevelopment of brain metastasis is one of the most serious complications of advanced melanoma, carrying a significant burden of morbidity and mortality. Although advances in local treatment modalities such as stereotactic radiosurgery and breakthrough systemic therapies including immunotherapy and targeted therapies have improved the outcomes of patients with metastatic melanoma, management of patients with melanoma brain metastases (MBMs) remains challenging. Notably, patients with MBMs have historically been excluded from clinical trials, ...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Afsaneh Amouzegar Hussein A Tawbi Source Type: research
Current Role and Status for Intratumoral Injection Therapies in Metastatic Melanoma
Cancer J. 2024 Mar-Apr 01;30(2):108-112. doi: 10.1097/PPO.0000000000000709.ABSTRACTIntratumoral therapies represent a unique avenue for drug development in melanoma as patients often have accessible lesions that are particularly amenable to these approaches. In addition, a majority of intratumoral therapies have focused on stimulating antitumor immune responses, making them a particularly attractive option for use in melanoma. In this review, we describe applications for talimogene laherparepvec, a US Food and Drug Administration-approved intratumoral therapy in melanoma, as well as several classes of intratumoral therapie...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Alexandra M Haugh Adil I Daud Source Type: research
Tumor-Infiltrating Lymphocyte and Other Cell Therapies for Metastatic Melanoma
Cancer J. 2024 Mar-Apr 01;30(2):113-119. doi: 10.1097/PPO.0000000000000705.ABSTRACTMajor progress in prolonging survival of patients with advanced melanoma has been made in the past decade because of the development and approval of immune checkpoint inhibitor and targeted therapies. However, for nonresponding or relapsing patients, their prognosis is still dismal. Based on clinical trial data, treatment with adoptive cell therapies holds great promise. In patients with metastatic melanoma progressing on or nonresponsive to single-agent anti-programmed cell death 1, infusion of tumor-infiltrating lymphocytes can produce res...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Christy Los Sebastian Klobuch John B A G Haanen Source Type: research
Is There a Current Role for Combination Chemotherapy or High-Dose Interleukin 2 in Melanoma?
Cancer J. 2024 Mar-Apr 01;30(2):120-125. doi: 10.1097/PPO.0000000000000703.ABSTRACTImmune checkpoint inhibition and targeted therapies have revolutionized the treatment of melanoma. However, chemotherapy and interleukin 2 (IL-2) therapy may still have a role in the later-line treatment of patients who do not have durable responses to other treatments. Chemotherapy can work transiently in patients whose disease has progressed on immune checkpoint inhibitors and for whom there are no appropriate targeted therapy options. High-dose IL-2 therapy can still be effective for a very small number of patients following progression o...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Julie Fishman Elizabeth I Buchbinder Source Type: research
Investigational Approaches for Treatment of Melanoma Patients Progressing After Standard of Care
Cancer J. 2024 Mar-Apr 01;30(2):126-131. doi: 10.1097/PPO.0000000000000702.ABSTRACTThe advent of effective immunotherapy, specifically cytotoxic T-lymphocyte associated protein 4 and programmed cell death 1 inhibitors, as well as targeted therapy including BRAF/MEK inhibitors, has dramatically changed the prognosis for metastatic melanoma patients. Up to 50% of patients may experience long-term survival currently. Despite these advances in melanoma treatment, many patients still progress and die of their disease. As such, there are many studies aimed at providing new treatment options for this population. Therapies current...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Kylie A Fletcher Douglas B Johnson Source Type: research
How Far We've Come
Cancer J. 2024 Mar-Apr 01;30(2):47. doi: 10.1097/PPO.0000000000000710.NO ABSTRACTPMID:38527256 | DOI:10.1097/PPO.0000000000000710 (Source: Cancer Journal)
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Mario Sznol Jeffrey S Weber Source Type: research
A General Approach to Patients Presenting With Locally Advanced or Distant Metastatic Disease
Cancer J. 2024 Mar-Apr 01;30(2):48-53. doi: 10.1097/PPO.0000000000000704.ABSTRACTThe widespread adoption of immune checkpoint inhibitors and small molecule inhibitors of the MAP kinase pathway has transformed the management of locally advanced and metastatic melanoma. Here, we provide a broad overview on the use of these agents in the first-line setting, incorporating a review of the clinical literature as well as the practice patterns of our respective melanoma groups. Throughout, we highlight areas of uncertainty that provide opportunities for future clinical investigation and additional improvement in outcomes for patie...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: James W Smithy Paul B Chapman Source Type: research
Treatment of Stage III Resectable Melanoma-Adjuvant and Neoadjuvant Approaches
Cancer J. 2024 Mar-Apr 01;30(2):54-70. doi: 10.1097/PPO.0000000000000706.ABSTRACTPatients with stage III resectable melanoma carry a high risk of melanoma recurrence that ranges from approximately 40% to 90% at 5 years following surgical management alone. Postoperative systemic adjuvant therapy targets residual micrometastatic disease that could be the source of future recurrence and death from melanoma. Randomized phase III adjuvant trials reported significant improvements in overall survival with high-dose interferon α in 2 of 3 studies (compared with observation and GMK ganglioside vaccine) and with anti-cytotoxic T-ly...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Ahmad A Tarhini Ella Castellano Islam Eljilany Source Type: research
Metastatic Melanoma Treatment in Special Populations
Cancer J. 2024 Mar-Apr 01;30(2):71-78. doi: 10.1097/PPO.0000000000000701.ABSTRACTThis review outlines the most up-to-date metastatic melanoma treatment recommendations and relevant risks for patients with solid organ transplants, patients with renal dysfunction, and patients with preexisting autoimmune conditions. These specific treatment populations were excluded from the original clinical trials, which studied immune checkpoint inhibitors and BRAF/MEK inhibitors in the advanced melanoma setting. We have synthesized the current body of literature, mainly case series and retrospective analyses, to reflect the evidence for ...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Madeline Miceli Christina Boatwright Janice M Mehnert Source Type: research
Melanoma-Modern Treatment for Metastatic Melanoma
Cancer J. 2024 Mar-Apr 01;30(2):79-83. doi: 10.1097/PPO.0000000000000707.ABSTRACTTraditional chemotherapy has been ineffective in the treatment of metastatic melanoma. Until the use of checkpoint inhibitors, patients had very limited survival. Since the original US Food and Drug Administration approval of ipilimumab over a decade ago, the armamentarium of immunotherapeutic agents has expanded to include programmed cell death protein 1 and lymphocyte activation gene 3 antibodies, requiring a nuanced approach to the selection of frontline treatments, managing patients through recurrence and progression, and determining lengt...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Maya Dimitrova Jeffrey Weber Source Type: research
What Is the Timing and Role of Targeted Therapy in Metastatic Melanoma?
Cancer J. 2024 Mar-Apr 01;30(2):84-91. doi: 10.1097/PPO.0000000000000712.ABSTRACTMelanoma is the most lethal cutaneous malignancy worldwide. The last 15 years have ushered in several regulatory approvals that have dramatically altered the landscape of treatment options for patients with melanoma. Many patients with melanoma harbor activating mutations in the BRAF proto-oncogene, a key component of the mitogen-activated protein kinase (MAPK) intracellular signaling pathway. Therapies targeting BRAF have led to remarkable improvements in both response rates and survival in patients with metastatic disease. In parallel with t...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Matthew J Hadfield Ryan J Sullivan Source Type: research
Updates in the Management of Uveal Melanoma
Cancer J. 2024 Mar-Apr 01;30(2):92-101. doi: 10.1097/PPO.0000000000000708.ABSTRACTUveal melanoma (UM), arising from intraocular melanocytes, poses a complex clinical challenge with a substantial risk of distant metastasis, often to the liver. Molecular profiling, encompassing genetic, cytogenetic, gene expression, and immunological subsets, plays a pivotal role in determining prognoses. The evolving landscape includes promising systemic treatments, such as tebentafusp, a novel immune-modulating bispecific fusion protein, and targeted therapies. Combined regional and systemic approaches, including immune checkpoint inhibito...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Mali Barbi Richard D Carvajal Craig E Devoe Source Type: research
Local and Systemic Management Options for Melanoma Brain Metastases
Cancer J. 2024 Mar-Apr 01;30(2):102-107. doi: 10.1097/PPO.0000000000000711.ABSTRACTDevelopment of brain metastasis is one of the most serious complications of advanced melanoma, carrying a significant burden of morbidity and mortality. Although advances in local treatment modalities such as stereotactic radiosurgery and breakthrough systemic therapies including immunotherapy and targeted therapies have improved the outcomes of patients with metastatic melanoma, management of patients with melanoma brain metastases (MBMs) remains challenging. Notably, patients with MBMs have historically been excluded from clinical trials, ...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Afsaneh Amouzegar Hussein A Tawbi Source Type: research
Current Role and Status for Intratumoral Injection Therapies in Metastatic Melanoma
Cancer J. 2024 Mar-Apr 01;30(2):108-112. doi: 10.1097/PPO.0000000000000709.ABSTRACTIntratumoral therapies represent a unique avenue for drug development in melanoma as patients often have accessible lesions that are particularly amenable to these approaches. In addition, a majority of intratumoral therapies have focused on stimulating antitumor immune responses, making them a particularly attractive option for use in melanoma. In this review, we describe applications for talimogene laherparepvec, a US Food and Drug Administration-approved intratumoral therapy in melanoma, as well as several classes of intratumoral therapie...
Source: Cancer Journal - March 25, 2024 Category: Cancer & Oncology Authors: Alexandra M Haugh Adil I Daud Source Type: research
