Molecular Characterization and Patient Outcome of Melanoma Nodal Metastases and an Unknown Primary Site

Gos, Aleksandra; Jurkowska, Monika; Akkooi, Alexander C. J. van; Robert, Caroline; Koseła-Paterczyk, Hanna; Koljenović, Senada; Kamsu‐Kom, Nyam; Michej, Wanda; Jeziorski, Arkadiusz; Pluta, Piotr; Verhoef, Cornelis; Siedlecki, Janusz A.; Eggermont, Alexander M.M.; Rutkowski, Piotr

doi:10.1245/s10434-014-3799-y

Cited by 25 publications

(17 citation statements)

References 40 publications

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“…Two thirds of the participants estimated that the skin was the most likely primary site for MUP, in agreement with recent studies demonstrating a similar molecular profile between MUP and melanomas on nonchronically sun-damaged skin [16,17] .…”

Section: Discussionsupporting

confidence: 89%

Unknown Primary Melanoma: Worldwide Survey on Clinical Management

et al. 2016

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Background: How to deal with melanoma of unknown primary (MUP) origin is a debated topic in the literature. Objective: We performed a worldwide survey to inquire what clinical and investigational workup is performed as well as the physicians' perception of this disease. Methods: A questionnaire was sent via mail to clinicians involved in melanoma care from December 2015 to April 2016 using the International Dermoscopy Society website. Results: 119 physicians from 47 different countries answered the questionnaire. The most reported examination was skin examination followed by CT and/or PET scans. All the participants declared asking about previous excisions of skin lesions with 81% of them asking for a histopathological slide review of previous biopsies. Half of the participants checked for a possible vitiligo phenomenon that may explain regression of the primary lesion. BRAF, cKIT, and GNAQ mutations were screened by 32% of participants. The majority of participants (76%) applied the same treatment protocols for MUP as patients with known primary melanomas of the same AJCC stage. Conclusion: Strong heterogeneity was found between physicians dealing with MUP. Thus, a consensus document should be strongly encouraged.

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Section: Discussionsupporting

confidence: 89%

Unknown Primary Melanoma: Worldwide Survey on Clinical Management

et al. 2016

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“…Although there are no specific treatment recommendations for patients with MUP, physicians tend to apply similar strategies for patients with stage‐matched MKP . This approach is supported by the results of a large study into the molecular characterisation of patients diagnosed with MUP, in which it was shown that the clinical behaviours and molecular patterns of BRAF/NRAS alterations were similar between patients with MUP and stage‐matched MKP …”

Section: Discussionmentioning

confidence: 96%

“…20 This approach is supported by the results of a large study into the molecular characterisation of patients diagnosed with MUP, in which it was shown that the clinical behaviours and molecular patterns of BRAF/NRAS alterations were similar between patients with MUP and stage-matched MKP. 21 The percentage of Dutch patients diagnosed with stage IV MUP who were primarily treated with novel therapy increased considerably during the study period. Consistent with the respective approval dates, targeted therapies (approved 2012-2015) were prescribed at higher rates early in the novel therapy era, whereas immunotherapies were prescribed at higher rates later in that era (approved 2011 and 2015-2016).…”

Section: Discussionmentioning

confidence: 99%

Treatment of melanoma of unknown primary in the era of immunotherapy and targeted therapy: A Dutch population‐based study

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Akkooi

et al. 2019

Intl Journal of Cancer

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Melanoma of unknown primary (MUP) may have a different biology to melanoma of known primary, but clinical trials of novel therapies (e.g., immune checkpoint or BRAF/MEK inhibitors) have not reported the outcomes in this population. We therefore evaluated the overall survival (OS) among patients with MUP in the era of novel therapy. Data for stage III or IV MUP were extracted from a nationwide database for the period 2003–2016, with classification based on the eighth edition of the American Joint Committee on Cancer criteria. The population was divided into pre‐ (2003–2010) and post‐ (2011–2016) novel therapy eras. Also, OS in the post‐novel era was compared between patients with stage IV MUP by whether they received novel therapy. In total, 2028 of 65,110 patients (3.1%) were diagnosed with MUP. Metastatic sites were known in 1919 of 2028 patients, and most had stage IV disease (53.8%). For patients with stage III MUP, the 5‐year OS rates were 48.5% and 50.2% in the pre‐ and post‐novel eras, respectively (p = 0.948). For those with stage IV MUP, the median OS durations were unchanged in the pre‐novel era and post‐novel era when novel therapy was not used (both 4 months); however, OS improved to 11 months when novel therapy was used in the post‐novel era (p < 0.001). In conclusion, more than half of the patients with MUP are diagnosed with stage IV and the introduction of novel therapy appears to have significantly improved the OS of these patients.

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“…Ved klinisk undersøkelse ble det funnet en palpabel knute i venstre lyske. Orienterende blodprøver viste senkning 23 mm (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), forhøyet CK 810 U/l (35-210), troponin T 134 ng/l (< 14), LD 294 U/l (105-205) samt negativ revmatoid faktor og antisykliske citrullinerte peptider. ANA var positiv (> 160), med negative undergrupper, inklusive myositt-og sklerodermaspesifikke antistoffer og de malignitetsassosierte antistoffene RNA-polymerase III, TIF1-γ og NXP-2.…”

Section: Figur 2 A) Kapillaroskopi Av Negleseng Hos Frisk Person Med unclassified

“…Det ble ikke sett tegn til arytmi ved 24 timers EKG eller ved fem dagers EKG-registrering. Orienterende blodprøver viste hemoglobin 12,9 g/dl (11,(7)(8)(9)(10)(11)(12)(13)(14)(15)3), senkning 26 mm (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). C-reaktivt protein, trombocytter og leukocytter var innen gjeldende referanseområder.…”

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