Treatment algorithms in stage IV melanoma.
Identifieur interne : 003205 ( PubMed/Corpus ); précédent : 003204; suivant : 003206Treatment algorithms in stage IV melanoma.
Auteurs : Enrique Espinosa ; 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 ]
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
Links to Exploration step
pubmed:24413374Le 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></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></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><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></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></analytic><series><title level="j">American journal of therapeutics</title><idno type="eISSN">1536-3686</idno></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Algorithms</term><term>Antineoplastic Agents (pharmacology)</term><term>Antineoplastic Agents (therapeutic use)</term><term>Clinical Trials as Topic (methods)</term><term>Drug Design</term><term>Genotype</term><term>Humans</term><term>Melanoma (drug therapy)</term><term>Melanoma (genetics)</term><term>Melanoma (pathology)</term><term>Neoplasm Staging</term><term>Skin Neoplasms (drug therapy)</term><term>Skin Neoplasms (genetics)</term><term>Skin Neoplasms (pathology)</term><term>Survival Rate</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Antineoplastic Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antineoplastic Agents</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Melanoma</term><term>Skin Neoplasms</term></keywords><keywords scheme="MESH" qualifier="genetics" xml:lang="en"><term>Melanoma</term><term>Skin Neoplasms</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Clinical Trials as Topic</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Melanoma</term><term>Skin Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Algorithms</term><term>Drug Design</term><term>Genotype</term><term>Humans</term><term>Neoplasm Staging</term><term>Survival Rate</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24413374</PMID><DateCreated><Year>2015</Year><Month>01</Month><Day>07</Day></DateCreated><DateCompleted><Year>2015</Year><Month>09</Month><Day>09</Day></DateCompleted><DateRevised><Year>2015</Year><Month>01</Month><Day>07</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1536-3686</ISSN><JournalIssue CitedMedium="Internet"><Volume>22</Volume><Issue>1</Issue><PubDate><MedlineDate>2015 Jan-Feb</MedlineDate></PubDate></JournalIssue><Title>American journal of therapeutics</Title><ISOAbbreviation>Am J Ther</ISOAbbreviation></Journal><ArticleTitle>Treatment algorithms in stage IV melanoma.</ArticleTitle><Pagination><MedlinePgn>61-7</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/MJT.0b013e31829e885c</ELocationID><Abstract><AbstractText>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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Espinosa</LastName><ForeName>Enrique</ForeName><Initials>E</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Grob</LastName><ForeName>Jean-Jacques</ForeName><Initials>JJ</Initials></Author><Author ValidYN="Y"><LastName>Dummer</LastName><ForeName>Reinhard</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Rutkowski</LastName><ForeName>Piotr</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Robert</LastName><ForeName>Caroline</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Gogas</LastName><ForeName>Helen</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>Kefford</LastName><ForeName>Richard</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Eggermont</LastName><ForeName>Alexander M M</ForeName><Initials>AM</Initials></Author><Author ValidYN="Y"><LastName>Martin Algarra</LastName><ForeName>Salvador</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Hauschild</LastName><ForeName>Axel</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Schadendorf</LastName><ForeName>Dirk</ForeName><Initials>D</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Ther</MedlineTA><NlmUniqueID>9441347</NlmUniqueID><ISSNLinking>1075-2765</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000970">Antineoplastic Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000465" MajorTopicYN="N">Algorithms</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000970" MajorTopicYN="N">Antineoplastic Agents</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002986" MajorTopicYN="N">Clinical Trials as Topic</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015195" MajorTopicYN="N">Drug Design</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005838" MajorTopicYN="N">Genotype</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008545" MajorTopicYN="N">Melanoma</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000235" MajorTopicYN="N">genetics</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009367" MajorTopicYN="N">Neoplasm Staging</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012878" MajorTopicYN="N">Skin Neoplasms</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000235" MajorTopicYN="N">genetics</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015996" MajorTopicYN="N">Survival Rate</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>1</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>1</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>9</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">24413374</ArticleId><ArticleId IdType="doi">10.1097/MJT.0b013e31829e885c</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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