Operable Melanoma: Screening, Prognostication, and Adjuvant and Neoadjuvant Therapy

Ahmad A. Tarhini, Paul Lorigan, Sancy Leachman

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

The importance of reducing the numbers of patients with late-stage melanoma, identifying which patients are most likely to progress, and treating these patients at the earliest possible stage cannot be overemphasized. Improved screening of patients prior to diagnosis has the advantage of identifying early-stage disease that is for the most part treatable by surgical methods. The process of melanoma screening is rapidly evolving through population-based programs, mobile health technologies, and advanced imaging tools. For patients with newly diagnosed melanoma, accurately estimating disease prognosis has important implications for management and follow-up. Prognostic factors are individual host- or tumor-related factors or molecules that correlate with genetic predisposition and clinical course. These include clinical covariates and host and tumor proteomic/genomic markers that allow the prognostic subclassification of patients. Adjuvant therapy for high-risk surgically resected melanoma targets residual micrometastatic disease with the goal of reducing the risk of relapse and mortality. In the United States, three regimens have achieved regulatory approval for adjuvant therapy, including high-dose interferon alpha, pegylated interferon alpha, and ipilimumab at 10 mg/kg. Phase III trials have reported benefits in relapse-free survival (all regimens) and overall survival (high-dose interferon alpha and ipilimumab). The management of locally/regionally advanced melanoma may benefit from neoadjuvant therapy, which is the subject of several ongoing studies. Recent studies have shown promising clinical activity and yielded important biomarker findings and mechanistic insights.

Original languageEnglish (US)
Pages (from-to)651-660
Number of pages10
JournalAmerican Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting
Volume37
DOIs
StatePublished - Jan 1 2017

Fingerprint

Neoadjuvant Therapy
Melanoma
Interferon-alpha
Recurrence
Biomedical Technology
Population Control
Survival
Telemedicine
Genetic Predisposition to Disease
Proteomics
Neoplasms
Biomarkers
Mortality
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{a24a9b9b20b546dcb9a4d25f5f18b2bc,
title = "Operable Melanoma: Screening, Prognostication, and Adjuvant and Neoadjuvant Therapy",
abstract = "The importance of reducing the numbers of patients with late-stage melanoma, identifying which patients are most likely to progress, and treating these patients at the earliest possible stage cannot be overemphasized. Improved screening of patients prior to diagnosis has the advantage of identifying early-stage disease that is for the most part treatable by surgical methods. The process of melanoma screening is rapidly evolving through population-based programs, mobile health technologies, and advanced imaging tools. For patients with newly diagnosed melanoma, accurately estimating disease prognosis has important implications for management and follow-up. Prognostic factors are individual host- or tumor-related factors or molecules that correlate with genetic predisposition and clinical course. These include clinical covariates and host and tumor proteomic/genomic markers that allow the prognostic subclassification of patients. Adjuvant therapy for high-risk surgically resected melanoma targets residual micrometastatic disease with the goal of reducing the risk of relapse and mortality. In the United States, three regimens have achieved regulatory approval for adjuvant therapy, including high-dose interferon alpha, pegylated interferon alpha, and ipilimumab at 10 mg/kg. Phase III trials have reported benefits in relapse-free survival (all regimens) and overall survival (high-dose interferon alpha and ipilimumab). The management of locally/regionally advanced melanoma may benefit from neoadjuvant therapy, which is the subject of several ongoing studies. Recent studies have shown promising clinical activity and yielded important biomarker findings and mechanistic insights.",
author = "Tarhini, {Ahmad A.} and Paul Lorigan and Sancy Leachman",
year = "2017",
month = "1",
day = "1",
doi = "10.14694/EDBK_174930",
language = "English (US)",
volume = "37",
pages = "651--660",
journal = "American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting",
issn = "1548-8756",
publisher = "American Society of Clinical Oncology",

}

TY - JOUR

T1 - Operable Melanoma

T2 - Screening, Prognostication, and Adjuvant and Neoadjuvant Therapy

AU - Tarhini, Ahmad A.

AU - Lorigan, Paul

AU - Leachman, Sancy

PY - 2017/1/1

Y1 - 2017/1/1

N2 - The importance of reducing the numbers of patients with late-stage melanoma, identifying which patients are most likely to progress, and treating these patients at the earliest possible stage cannot be overemphasized. Improved screening of patients prior to diagnosis has the advantage of identifying early-stage disease that is for the most part treatable by surgical methods. The process of melanoma screening is rapidly evolving through population-based programs, mobile health technologies, and advanced imaging tools. For patients with newly diagnosed melanoma, accurately estimating disease prognosis has important implications for management and follow-up. Prognostic factors are individual host- or tumor-related factors or molecules that correlate with genetic predisposition and clinical course. These include clinical covariates and host and tumor proteomic/genomic markers that allow the prognostic subclassification of patients. Adjuvant therapy for high-risk surgically resected melanoma targets residual micrometastatic disease with the goal of reducing the risk of relapse and mortality. In the United States, three regimens have achieved regulatory approval for adjuvant therapy, including high-dose interferon alpha, pegylated interferon alpha, and ipilimumab at 10 mg/kg. Phase III trials have reported benefits in relapse-free survival (all regimens) and overall survival (high-dose interferon alpha and ipilimumab). The management of locally/regionally advanced melanoma may benefit from neoadjuvant therapy, which is the subject of several ongoing studies. Recent studies have shown promising clinical activity and yielded important biomarker findings and mechanistic insights.

AB - The importance of reducing the numbers of patients with late-stage melanoma, identifying which patients are most likely to progress, and treating these patients at the earliest possible stage cannot be overemphasized. Improved screening of patients prior to diagnosis has the advantage of identifying early-stage disease that is for the most part treatable by surgical methods. The process of melanoma screening is rapidly evolving through population-based programs, mobile health technologies, and advanced imaging tools. For patients with newly diagnosed melanoma, accurately estimating disease prognosis has important implications for management and follow-up. Prognostic factors are individual host- or tumor-related factors or molecules that correlate with genetic predisposition and clinical course. These include clinical covariates and host and tumor proteomic/genomic markers that allow the prognostic subclassification of patients. Adjuvant therapy for high-risk surgically resected melanoma targets residual micrometastatic disease with the goal of reducing the risk of relapse and mortality. In the United States, three regimens have achieved regulatory approval for adjuvant therapy, including high-dose interferon alpha, pegylated interferon alpha, and ipilimumab at 10 mg/kg. Phase III trials have reported benefits in relapse-free survival (all regimens) and overall survival (high-dose interferon alpha and ipilimumab). The management of locally/regionally advanced melanoma may benefit from neoadjuvant therapy, which is the subject of several ongoing studies. Recent studies have shown promising clinical activity and yielded important biomarker findings and mechanistic insights.

UR - http://www.scopus.com/inward/record.url?scp=85045548398&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045548398&partnerID=8YFLogxK

U2 - 10.14694/EDBK_174930

DO - 10.14694/EDBK_174930

M3 - Review article

C2 - 28561661

AN - SCOPUS:85045548398

VL - 37

SP - 651

EP - 660

JO - American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting

JF - American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting

SN - 1548-8756

ER -