Developments in Intralesional Therapy for Metastatic Melanoma

Abstract

Background Locoregional advanced melanoma poses a complex clinical challenge that requires a multidisciplinary, patient-centered approach. Numerous agents have been studied for their suitability as intralesional therapy in the past decades, but few have successfully completed phase 3 clinical trial testing. Methods The relevant medical literature was searched for articles regarding use of intralesional therapies in metastatic melanoma. Therapies with data from phase 2 or higher studies were selected for review. This review also summarizes the mechanisms of action, adverse-event profiles, and clinical data for these agents. Results Intralesional therapies demonstrate promising effects in select patients and are a valuable asset to the current treatment options in advanced melanoma. The optimal approach should be tailored to the individual patient and consists of a combination of intralesional therapies, regional perfusions, systemic immunotherapies, targeted therapies and/or surgery. Conclusions Due to relatively good local response rates and tolerable adverse-event profile, intralesional therapy may be a treatment option for patients with unresectable locally advanced or metastatic melanoma.

MRI-Guided Cryoablation of In-Transit Metastases from Cutaneous Melanoma: A Brief Report on a Preliminary Experience

“…The NCCN guidelines provided A. Rauch et al: MRI-Guided Cryoablation of In-Transit Metastases from Cutaneous Melanoma… a wide range of therapeutic options for IT metastases, including surgical resection, intra-lesional and topical treatments, local radiation therapy, regional therapies such as isolated limb infusion (ILI) and isolated limb perfusion (ILP); and systemic agents such as chemotherapies, interferon (IFN) and novel immunologic drugs (anti-CTLA4 and anti-PD-1 antibodies) [2, 6,7]. Our results seem to compare favourably in terms of local tumour control when compared both to local and regional treatments (87.5% of primary local control at 12-months in our series versus up to 89% with local therapies and up to 82% with regional therapies) [2, [6][7][8]. Moreover, CA proved to be well tolerated by all patients who were able to walk 4-6 hours after the procedure; and, all patients were discharged from the hospital as planned on the day following the procedure, without any need of painkillers.…”

Monodisperse and Uniform Mesoporous Silicate Nanosensitizers Achieve Low‐Dose X‐Ray‐Induced Deep‐Penetrating Photodynamic Therapy

“…In the present research, we chose the ZSM ScNPs whose XEOL overlapped well with the absorption spectrum of RB (Figure e, blue curve). As a clinical agent, RB has been used for half a century to diagnose liver and eye cancer, and is being evaluated as a single agent therapy for patients with locally advanced cutaneous melanoma (NCT02288897) . In addition, one RB molecule has four iodine atoms, which would contribute to absorbing X‐ray energy for computed tomography (CT) imaging and enhanced radiotherapy …”

Bacillus Calmette‐Guerin, polysaccharide nucleic acid in the treatment of cutaneous and oral lichen planus

“…BCG‐PSN regulates subsets of T cells, induces T helper type‐1 immunity (Th1) and enhancing the cellular immunity (Chun, ). BCG‐PSN had therapeutic benefits for treatment of several diseases as idiopathic urticaria, (Li, Cao, & Niu, ) alopecia areata (Chun, ), melanoma (Sloot, Rashid, Sarnaik, & Zager, ), warts (Zuo, Huang, & Liao, ), recurrent oral aphthosis (Sharquie & Hayani, ) and vitiligo (Zhan, Xiong, & Wang, ).…”