Sarcoid-like reaction in a BRAF V600E-mutated metastatic melanoma patient during treatment with BRAF/MEK-targeted therapy
We describe a 48-year-old female patient who initially presented with solitary brain metastasis and diffuse lung lesions. She was treated with D/T to which she had an initial response in all lesions. One year later, new hilar and mediastinal lymphadenopathies were detected. Imaging was suggestive of the sarcoid-like syndrome. An endoscopic biopsy of the enlarged lymph node showed no melanoma cells. Treatment was continued. Three months later, the patient experienced a drop in hemoglobin, which prompted further investigations into possible occult intestinal metastasis. Video capsule examination revealed a metastatic lesion ...
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Short Communication: Clinical Research Source Type: research
Extreme elevation of acute phase reactants and shock secondary to dabrafenib–trametinib
We present the case of a patient diagnosed with stage IV melanoma BRAF Val600E mutated who was started on dabrafenib and trametinib and developed three severe episodes of fever, hypotension and acute phase reactants elevation during the first 3 months of therapy, in the absence of microbiological demonstration of infection. The episodes were initially managed as a septic shock with broad-spectrum antibiotics and vasoactive drugs, while treatment with dabrafenib and trametinib was withheld. After two subsequent dose reduction of dabrafenib, the patient did not experience new episodes of fever. (Source: Melanoma Research)
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Short Communication: Clinical Research Source Type: research
Melanoma-specific expression of the tumor suppressor proteins p16 and PTEN is a favorable prognostic factor in established melanoma brain metastases
PTEN and p16 frequently undergo (epi)genetic aberrations in melanoma resulting in decreased, or absent, protein levels. We investigated the prognostic significance of these tumor suppressor genes in melanoma brain metastases (MBMs). Immunohistochemical analysis was performed on archived tissue sections from craniotomies. Expression of PTEN and p16 was semiquantitatively scored (0–3 scale) in melanoma cells, glia, TILs, and endothelial cells of tumor-associated vessels and was compared among the different brain tumor cell compartments. Overall survival (OS) analysis was performed according to PTEN and p16 protein expressi...
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Short Communication: Translational Research Source Type: research
Impact of the development of immune related adverse events in metastatic melanoma treated with PD -1 inhibitors
Some clinical trials have described improved outcomes in patients who develop immune-related adverse events (irAEs) while receiving immune checkpoint inhibitors for advanced melanoma. It is unknown if this effect would be seen in a real-world population. This is a single-center retrospective analysis of all patients receiving single-agent PD-1 inhibitor for unresectable stage III or stage IV melanoma between 2012 and 2018. The majority of patients had cutaneous melanoma and were elderly (put in median and range). Totally 33.3% were BRAF mutated and 66.7% had PD-1 inhibitor as first-line treatment for metastatic disease. Al...
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Original Articles: Clinical Research Source Type: research
Real-world healthcare costs of localized and regionally advanced cutaneous melanoma in the Netherlands
In conclusion, healthcare costs of patients with localized and regionally advanced melanoma were rather low for the initial treatment. Costs became, however, more substantial in case of disease recurrence. In the context of a rapidly changing treatment paradigm, it remains crucial to monitor treatment outcomes as well as healthcare expenditures. (Source: Melanoma Research)
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Original Articles: Clinical Research Source Type: research
Response to immune checkpoint inhibitor rechallenge after high-grade immune related adverse events in patients with advanced melanoma
Twenty to sixty percent of patients receiving immune checkpoint inhibitors (ICIs) experience high-grade immune-related adverse events (irAEs) which may prevent the continuation of treatment. Limited clinical evidence is available to guide treatment for these patients. Patients with stage IV or unresectable stage III melanoma at NYU Langone Health were reviewed from 1 January 2014 to 1 July 2019. Patients with first-line ICI systemic therapy, a high-grade irAE and a rechallenge with ICI therapy were included. Postrechallenge irAE recurrence, response rate, overall survival (OS) and progression-free survival (PFS) were evalu...
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Original Articles: Clinical Research Source Type: research
Treatment of in-transit melanoma metastases using intralesional PV-10
Melanoma in-transit metastases (ITMs) can sometimes be difficult to manage by surgical excision due to their number, size or location. Treatment by intralesional injection of PV-10, a 10% solution of rose bengal, has been reported to be a simple, safe and effective alternative, but more outcome data are required to confirm its value in the management of ITMs. Two hundred and twenty-six melanoma ITMs in 48 patients were treated with intralesional PV-10 supplied under a special-access scheme. By 8 weeks a complete response in all injected ITMs was achieved in 22 patients (46%) and a partial response in 19 patients (40%). Of ...
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Original Articles: Clinical Research Source Type: research
Impact of staging on survival outcomes: a nationwide real-world cohort study of metastatic uveal melanoma
No data exist regarding whether any first-line treatment for metastatic uveal melanoma provides overall survival (OS) benefit, if staged and compared to best supportive care (BSC). We analyzed OS in a nationwide, consecutive cohort diagnosed with metastatic uveal melanoma between January 1999 and December 2016. The Helsinki University Hospital Working Formulation was used to assign patients to stage IVa, IVb and IVc, corresponding to predicted median OS ≥12, (Source: Melanoma Research)
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Original Articles: Clinical Research Source Type: research
BRAF inhibitor treatment is feasible in the oldest-old advanced melanoma patients
Although new compounds have improved the treatment landscape of metastatic melanoma, very limited data exist on the efficacy and safety of treating older patients with novel agents. Here, we provide results of BRAF (BRAFi) ± MEK (MEKi) inhibitor treatment in patients over 75 years (oldest-old patients) with metastatic melanoma. Between 2011 and 2020, 34 consecutive patients with metastatic melanoma over 75 years of age (range 75–89) were treated with BRAFi ± MEKi at the Comprehensive Cancer Center of Helsinki University Hospital. Data on clinical and histopathological features, toxicity, response rate (RR),...
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Original Articles: Clinical Research Source Type: research
Prognostic impact of thyroid dysfunctions on progression-free survival in patients with metastatic melanoma treated with anti-PD-1 antibodies
This study aimed to assess the prognostic value of thyroid dysfunctions in metastatic melanoma patients on anti-programmed death-1 (anti-PD-1). A total of 110 stage IV or inoperable stage III melanoma patients treated with anti-PD-1 alone or in association with anti-CTLA-4 (T-lymphocyte antigen-4) antibody from January 2015 to December 2017 at our institution were enrolled in this retrospective study. Median follow-up was 32.8 months. Transitory thyroid dysfunctions and permanent thyroid dysfunctions were distinguished. The main criterion was progression-free survival. Secondary criteria were best response and overall surv...
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Original Articles: Translational Research Source Type: research
A novel C-terminal Hsp90 inhibitor KU758 synergizes efficacy in combination with BRAF or MEK inhibitors and targets drug-resistant pathways in BRAF-mutant melanomas
Melanoma remains the most aggressive and fatal form of skin cancer, despite several FDA-approved targeted chemotherapies and immunotherapies for use in advanced disease. Of the 100 350 new patients diagnosed with melanoma in 2020 in the US, more than half will develop metastatic disease leading to a 5-year survival rate (Source: Melanoma Research)
Source: Melanoma Research - May 13, 2021 Category: Cancer & Oncology Tags: Original Articles: Basic Science Source Type: research
Choroidal melanoma treatment in times of coronavirus disease 2019
No abstract available (Source: Melanoma Research)
Source: Melanoma Research - March 11, 2021 Category: Cancer & Oncology Tags: Letter to the Editor Source Type: research
A case of sudden brain metastases progression after temporary targeted therapy discontinuation: when to regret a drug holiday
This report presents a 78-year-old woman with metastatic BRAF V600E positive melanoma (bladder and brain localizations). The patient started first-line dabrafenib and trametinib with good tolerability and evidence of complete response (CR). After 8 months of maintained CR, the patient took a drug holiday for 14 days. Brain MRI performed after treatment pause showed extensive disease progression, whereas extracranial staging was negative. The patient was asymptomatic: she restarted targeted therapy and underwent evaluation for whole-brain radiotherapy. Brain computed tomography scan and subsequent MRI performed to plan ...
Source: Melanoma Research - March 11, 2021 Category: Cancer & Oncology Tags: Short Communications: Clinical Research Source Type: research
Unexpected pure red series aplastic anemia secondary to pembrolizumab treatment: a case report and literature review
Pembrolizumab is a treatment that has shown a survival benefit in patients with metastatic melanoma. Programmed death receptor 1 inhibitors are new therapeutic agents that produce clinical responses with a more manageable profile of adverse effects compared to chemotherapy. The most frequent adverse effects include fatigue, rash, myalgia, pyrexia and cough, with less frequent occurrence of immune-mediated adverse reactions such as colitis, pneumonitis, hepatitis and encephalitis. Immune-related hematological toxicities have been poorly described. Here we present the case of a patient with metastatic melanoma who develops p...
Source: Melanoma Research - March 11, 2021 Category: Cancer & Oncology Tags: Short Communications: Clinical Research Source Type: research
The efficacy of immunotherapy for in-transit metastases of melanoma: an analysis of randomized controlled trials
This study aimed to identify patients with unresectable ITM within the randomized trials, and to determine response, progression-free survival and overall survival. The pivotal phase III randomized intervention trials that included melanoma patients with ITM, with or without nodal metastasis, and were treated with ipilimumab, nivolumab or pembrolizumab was identified. The datasets from each trial were then searched to identify the specific details of the investigated patient population for a pooled analysis. The primary endpoint was complete response rate. Seven trials that included stage III patients, and with accessible ...
Source: Melanoma Research - March 11, 2021 Category: Cancer & Oncology Tags: Short Communications: Clinical Research Source Type: research
