Treatment algorithms in stage IV melanoma.
Identifieur interne : 00E272 ( Main/Exploration ); précédent : 00E271; suivant : 00E273Treatment algorithms in stage IV melanoma.
Auteurs : Enrique Espinosa [Allemagne] ; Jean-Jacques Grob ; Reinhard Dummer ; Piotr Rutkowski ; Caroline Robert ; Helen Gogas ; Richard Kefford ; Alexander M M. Eggermont ; Salvador Martin Algarra ; Axel Hauschild ; Dirk SchadendorfSource :
- American journal of therapeutics [ 1536-3686 ]
Descripteurs français
- KwdFr :
- Algorithmes, Antinéoplasiques (pharmacologie), Antinéoplasiques (usage thérapeutique), Conception de médicament, Essais cliniques comme sujet (), Génotype, Humains, Mélanome (anatomopathologie), Mélanome (génétique), Mélanome (traitement médicamenteux), Stade de la tumeur, Taux de survie, Tumeurs cutanées (anatomopathologie), Tumeurs cutanées (génétique), Tumeurs cutanées (traitement médicamenteux).
- MESH :
- anatomopathologie : Mélanome, Tumeurs cutanées.
- génétique : Mélanome, Tumeurs cutanées.
- pharmacologie : Antinéoplasiques.
- traitement médicamenteux : Mélanome, Tumeurs cutanées.
- usage thérapeutique : Antinéoplasiques.
- Algorithmes, Conception de médicament, Essais cliniques comme sujet, Génotype, Humains, Stade de la tumeur, Taux de survie.
English descriptors
- KwdEn :
- Algorithms, Antineoplastic Agents (pharmacology), Antineoplastic Agents (therapeutic use), Clinical Trials as Topic (methods), Drug Design, Genotype, Humans, Melanoma (drug therapy), Melanoma (genetics), Melanoma (pathology), Neoplasm Staging, Skin Neoplasms (drug therapy), Skin Neoplasms (genetics), Skin Neoplasms (pathology), Survival Rate.
- MESH :
- chemical , pharmacology : Antineoplastic Agents.
- chemical , therapeutic use : Antineoplastic Agents.
- drug therapy : Melanoma, Skin Neoplasms.
- genetics : Melanoma, Skin Neoplasms.
- methods : Clinical Trials as Topic.
- pathology : Melanoma, Skin Neoplasms.
- Algorithms, Drug Design, Genotype, Humans, Neoplasm Staging, Survival Rate.
Abstract
The molecular classification of melanoma and the advent of new drugs are changing the paradigm of therapy for advanced melanoma. A review of the recent key studies was performed, followed by a discussion in an expert forum. The aim of this review was to generate a therapeutic algorithm for stage IV melanoma. Tumor genotyping for BRAF and/or KIT should be performed before selection of therapy. For most BRAF-mutated melanoma patients and particularly those with a high tumor load, vemurafenib or other BRAF inhibitors such as dabrafenib are the treatment of choice. KIT inhibitors can be effective in KIT-mutant tumors, especially in those patients with mutations at exons 11 and 13. Ipilimumab is a good option for patients with nontargetable or nondetected mutations and those who progress under therapy with vemurafenib or a KIT inhibitor. There is still a role for conventional chemotherapy either as first-line treatment in BRAF wild-type patients or as salvage therapy in second or third line, or after other treatment modalities. Participation in clinical trials is strongly encouraged, either in first or in subsequent lines. New therapeutic options for advanced melanoma are guided by tumor genotyping. The current therapeutic algorithm includes kinase inhibitors, anti-CTLA4 therapy, immunotherapy, and chemotherapy, depending on the tumor genotype and response to previous treatments. Participation in clinical trials should always be encouraged because the treatment goal is long-term survival and potential cure in a subset of patients.
DOI: 10.1097/MJT.0b013e31829e885c
PubMed: 24413374
Affiliations:
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Le document en format XML
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Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; 5Department of Dermatology (CR), and General Director (AE), Institute Gustave Roussy, Villejuif Cedex, France; 6First Department of Medicine, University of Athens Medical School, Athens, Greece; 7Department of Oncology, Westmead Hospital and Melanoma Institute Australia, University of Sydney, Sydney, Australia; 8Service of Oncology, Clinica Universitaria de Navarra, Pamplona, Spain; 9Department of Dermatology, University of Kiel, Kiel, Germany; and 10Department of Dermatology, University Hospital Essen, Essen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>1Service of Oncology, Hospital La Paz, Madrid, Spain; 2Department of Dermatology, Hopital Ste Marguerite, Marseille, France; 3Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland; 4Department of Sarcoma and Melanoma, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; 5Department of Dermatology (CR), and General Director (AE), Institute Gustave Roussy, Villejuif Cedex, France; 6First Department of Medicine, University of Athens Medical School, Athens, Greece; 7Department of Oncology, Westmead Hospital and Melanoma Institute Australia, University of Sydney, Sydney, Australia; 8Service of Oncology, Clinica Universitaria de Navarra, Pamplona, Spain; 9Department of Dermatology, University of Kiel, Kiel, Germany; and 10Department of Dermatology, University Hospital Essen, Essen</wicri:regionArea><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author><author><name sortKey="Grob, Jean Jacques" sort="Grob, Jean Jacques" uniqKey="Grob J" first="Jean-Jacques" last="Grob">Jean-Jacques Grob</name></author><author><name sortKey="Dummer, Reinhard" sort="Dummer, Reinhard" uniqKey="Dummer R" first="Reinhard" last="Dummer">Reinhard Dummer</name></author><author><name sortKey="Rutkowski, Piotr" sort="Rutkowski, Piotr" uniqKey="Rutkowski P" first="Piotr" last="Rutkowski">Piotr Rutkowski</name></author><author><name sortKey="Robert, Caroline" sort="Robert, Caroline" uniqKey="Robert C" first="Caroline" last="Robert">Caroline Robert</name></author><author><name sortKey="Gogas, Helen" sort="Gogas, Helen" uniqKey="Gogas H" first="Helen" last="Gogas">Helen Gogas</name></author><author><name sortKey="Kefford, Richard" sort="Kefford, Richard" uniqKey="Kefford R" first="Richard" last="Kefford">Richard Kefford</name></author><author><name sortKey="Eggermont, Alexander M M" sort="Eggermont, Alexander M M" uniqKey="Eggermont A" first="Alexander M M" last="Eggermont">Alexander M M. Eggermont</name></author><author><name sortKey="Martin Algarra, Salvador" sort="Martin Algarra, Salvador" uniqKey="Martin Algarra S" first="Salvador" last="Martin Algarra">Salvador Martin Algarra</name></author><author><name sortKey="Hauschild, Axel" sort="Hauschild, Axel" uniqKey="Hauschild A" first="Axel" last="Hauschild">Axel Hauschild</name></author><author><name sortKey="Schadendorf, Dirk" sort="Schadendorf, Dirk" uniqKey="Schadendorf D" first="Dirk" last="Schadendorf">Dirk Schadendorf</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="????"><PubDate><MedlineDate>2015 Jan-Feb</MedlineDate></PubDate></date><idno type="RBID">pubmed:24413374</idno><idno type="pmid">24413374</idno><idno type="doi">10.1097/MJT.0b013e31829e885c</idno><idno type="wicri:Area/PubMed/Corpus">003205</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">003205</idno><idno type="wicri:Area/PubMed/Curation">003095</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">003095</idno><idno type="wicri:Area/PubMed/Checkpoint">003095</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">003095</idno><idno type="wicri:Area/Ncbi/Merge">001708</idno><idno type="wicri:Area/Ncbi/Curation">001708</idno><idno type="wicri:Area/Ncbi/Checkpoint">001708</idno><idno type="wicri:Area/Main/Merge">00F512</idno><idno type="wicri:Area/Main/Curation">00E272</idno><idno type="wicri:Area/Main/Exploration">00E272</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Treatment algorithms in stage IV melanoma.</title><author><name sortKey="Espinosa, Enrique" sort="Espinosa, Enrique" uniqKey="Espinosa E" first="Enrique" last="Espinosa">Enrique Espinosa</name><affiliation wicri:level="1"><nlm:affiliation>1Service of Oncology, Hospital La Paz, Madrid, Spain; 2Department of Dermatology, Hopital Ste Marguerite, Marseille, France; 3Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland; 4Department of Sarcoma and Melanoma, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; 5Department of Dermatology (CR), and General Director (AE), Institute Gustave Roussy, Villejuif Cedex, France; 6First Department of Medicine, University of Athens Medical School, Athens, Greece; 7Department of Oncology, Westmead Hospital and Melanoma Institute Australia, University of Sydney, Sydney, Australia; 8Service of Oncology, Clinica Universitaria de Navarra, Pamplona, Spain; 9Department of Dermatology, University of Kiel, Kiel, Germany; and 10Department of Dermatology, University Hospital Essen, Essen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>1Service of Oncology, Hospital La Paz, Madrid, Spain; 2Department of Dermatology, Hopital Ste Marguerite, Marseille, France; 3Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland; 4Department of Sarcoma and Melanoma, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; 5Department of Dermatology (CR), and General Director (AE), Institute Gustave Roussy, Villejuif Cedex, France; 6First Department of Medicine, University of Athens Medical School, Athens, Greece; 7Department of Oncology, Westmead Hospital and Melanoma Institute Australia, University of Sydney, Sydney, Australia; 8Service of Oncology, Clinica Universitaria de Navarra, Pamplona, Spain; 9Department of Dermatology, University of Kiel, Kiel, Germany; and 10Department of Dermatology, University Hospital Essen, Essen</wicri:regionArea><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author><author><name sortKey="Grob, Jean Jacques" sort="Grob, Jean Jacques" uniqKey="Grob J" first="Jean-Jacques" last="Grob">Jean-Jacques Grob</name></author><author><name sortKey="Dummer, Reinhard" sort="Dummer, Reinhard" uniqKey="Dummer R" first="Reinhard" last="Dummer">Reinhard Dummer</name></author><author><name sortKey="Rutkowski, Piotr" sort="Rutkowski, Piotr" uniqKey="Rutkowski P" first="Piotr" last="Rutkowski">Piotr Rutkowski</name></author><author><name sortKey="Robert, Caroline" sort="Robert, Caroline" uniqKey="Robert C" first="Caroline" last="Robert">Caroline Robert</name></author><author><name sortKey="Gogas, Helen" sort="Gogas, Helen" uniqKey="Gogas H" first="Helen" last="Gogas">Helen Gogas</name></author><author><name sortKey="Kefford, Richard" sort="Kefford, Richard" uniqKey="Kefford R" first="Richard" last="Kefford">Richard Kefford</name></author><author><name sortKey="Eggermont, Alexander M M" sort="Eggermont, Alexander M M" uniqKey="Eggermont A" first="Alexander M M" last="Eggermont">Alexander M M. 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A review of the recent key studies was performed, followed by a discussion in an expert forum. The aim of this review was to generate a therapeutic algorithm for stage IV melanoma. Tumor genotyping for BRAF and/or KIT should be performed before selection of therapy. For most BRAF-mutated melanoma patients and particularly those with a high tumor load, vemurafenib or other BRAF inhibitors such as dabrafenib are the treatment of choice. KIT inhibitors can be effective in KIT-mutant tumors, especially in those patients with mutations at exons 11 and 13. Ipilimumab is a good option for patients with nontargetable or nondetected mutations and those who progress under therapy with vemurafenib or a KIT inhibitor. There is still a role for conventional chemotherapy either as first-line treatment in BRAF wild-type patients or as salvage therapy in second or third line, or after other treatment modalities. Participation in clinical trials is strongly encouraged, either in first or in subsequent lines. New therapeutic options for advanced melanoma are guided by tumor genotyping. The current therapeutic algorithm includes kinase inhibitors, anti-CTLA4 therapy, immunotherapy, and chemotherapy, depending on the tumor genotype and response to previous treatments. Participation in clinical trials should always be encouraged because the treatment goal is long-term survival and potential cure in a subset of patients.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country></list><tree><noCountry><name sortKey="Dummer, Reinhard" sort="Dummer, Reinhard" uniqKey="Dummer R" first="Reinhard" last="Dummer">Reinhard Dummer</name><name sortKey="Eggermont, Alexander M M" sort="Eggermont, Alexander M M" uniqKey="Eggermont A" first="Alexander M M" last="Eggermont">Alexander M M. Eggermont</name><name sortKey="Gogas, Helen" sort="Gogas, Helen" uniqKey="Gogas H" first="Helen" last="Gogas">Helen Gogas</name><name sortKey="Grob, Jean Jacques" sort="Grob, Jean Jacques" uniqKey="Grob J" first="Jean-Jacques" last="Grob">Jean-Jacques Grob</name><name sortKey="Hauschild, Axel" sort="Hauschild, Axel" uniqKey="Hauschild A" first="Axel" last="Hauschild">Axel Hauschild</name><name sortKey="Kefford, Richard" sort="Kefford, Richard" uniqKey="Kefford R" first="Richard" last="Kefford">Richard Kefford</name><name sortKey="Martin Algarra, Salvador" sort="Martin Algarra, Salvador" uniqKey="Martin Algarra S" first="Salvador" last="Martin Algarra">Salvador Martin Algarra</name><name sortKey="Robert, Caroline" sort="Robert, Caroline" uniqKey="Robert C" first="Caroline" last="Robert">Caroline Robert</name><name sortKey="Rutkowski, Piotr" sort="Rutkowski, Piotr" uniqKey="Rutkowski P" first="Piotr" last="Rutkowski">Piotr Rutkowski</name><name sortKey="Schadendorf, Dirk" sort="Schadendorf, Dirk" uniqKey="Schadendorf D" first="Dirk" last="Schadendorf">Dirk Schadendorf</name></noCountry><country name="Allemagne"><noRegion><name sortKey="Espinosa, Enrique" sort="Espinosa, Enrique" uniqKey="Espinosa E" first="Enrique" last="Espinosa">Enrique Espinosa</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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