Japanese Dermatological Association Guidelines: Outlines of guidelines for cutaneous melanoma 2019

Abstract

With consideration of the ongoing developments in treatment options for cutaneous melanoma, the Japanese Skin Cancer Society published the first guidelines for cutaneous melanoma in 2007 and later revised them in 2015. Here, we report on an English version of the 2019 Japanese Melanoma Guidelines. In this latest edition, all processes were carried out according to the Grading of Recommendations, Assessment, Development and Evaluation system. A comprehensive published work search, systematic review and determination of recommendations in each clinical question were performed by a multidisciplinary expert panel consisting of dermatologists, a plastic and reconstructive surgeon, and a radiation oncologist. The advent of novel agents, such as immune checkpoint inhibitors and molecular-targeted agents, has drastically changed the nature of treatment for adjuvant and advanced-stage diseases among melanoma patients worldwide. Additionally, recent reports of clinical trials regarding surgical procedures and a better understanding of molecular biology and tumor immunology in clinical types of melanoma have had an impact on clinical practise. Based on these viewpoints, eight relevant clinical questions were raised in this report that aim to help clinicians select the appropriate therapeutic approach.

Final analysis of a phase II study of nivolumab in combination with ipilimumab for unresectable chemotherapy‐naive advanced melanoma

“…The survival benefit of nivolumab plus ipilimumab has been shown in clinical studies of patients with advanced melanoma, 4–7 advanced renal‐cell carcinoma, 8 and non‐small‐cell lung cancer 9 . Currently, nivolumab plus ipilimumab combination is considered to be one of the preferred regimens as the first‐line systemic therapy for advanced melanoma in recently updated clinical practice guidelines for melanoma 10–12 …”

Comprehensive clinicopathological and molecular analysis of primary malignant melanoma of the oesophagus

“…12 The identification of several active molecular aberrations, such as BRAF V600E mutations, has resulted in molecular targeted therapy with BRAF and MEK inhibitors in patients with CM, and has contributed to the improved prognosis. 13,14 Recent genetic studies have also focused on less frequent melanoma subtypes, such as AM, as well as PMME. 10,[15][16][17][18] Hayward et al reported that AM was associated with more frequent chromosomal alterations and a lower tumour mutation burden (TMB) than non-acral skin melanoma.…”

“…CMs are genetically classified as BRAF‐ mutant (50%), RAS‐ mutant (20–30%), NF1 ‐mutant (10–15%), or triple wild‐type (10–15%) 12 . The identification of several active molecular aberrations, such as BRAF V600 E mutations, has resulted in molecular targeted therapy with BRAF and MEK inhibitors in patients with CM, and has contributed to the improved prognosis 13,14 . Recent genetic studies have also focused on less frequent melanoma subtypes, such as AM, as well as PMME 10,15–18 .…”

Laparoscopic-assisted distal gastrectomy and central pancreatectomy for gastric and perigastric lymph node metastases and pancreatic invasion from melanoma: a case report

“…Melanoma with distant metastases is a malignant neoplasm with a poor prognosis. In melanoma, completely resectable metastases, so-called oligometastases, are surgically resected to expect to prolong relapse-free survival and overall survival [ 1 ]. However, in most cases with metastatic melanoma, multiple metastases are present at the time of diagnosis and are rarely indicated for surgery.…”

“…survival and overall survival [1]. However, in most cases with metastatic melanoma, multiple metastases are present at the time of diagnosis and are rarely indicated for surgery.…”