Systemic therapy of malignant melanoma

Abstract

The present status of medical treatment of malignant melanoma is briefly reviewed, both with regard to adjuvant therapy for individuals with high-risk melanoma and a high probability of harbouring subclinical micrometastases, as well as to therapy for established disseminated (macrometastatic) disease. At present, disseminated, macrometastatic melanoma is incurable in the majority of cases. Single agent chemotherapy has modest effects and results in disease remission in a minority of patients, usually of short duration, Combination chemotherapy, or the combination of chemotherapeutic drugs and cytokines, results in increased response rates and occasionally remissions of prolonged duration. So far, no regimen has demonstrated improved survival compared to single agent therapy in disseminated melanoma. New insights into the mechanisms of resistance to chemotherapeutic drugs may lead to development of predictive tests that can identify individuals with tumors sensitive to a specific agent, as well as to the development of strategies to circumvent drug resistance. It has recently been shown that adjuvant therapy of high-risk melanoma with large doses of interferon-alpha 2b significantly prolongs relapse-free and overall survival, at the price of considerable toxicity. Ongoing studies aim to define the optimum dose and duration of adjuvant interferon therapy. Recent advances in molecular biology and immunology may lead to the development of new treatment modalities, such as improved vaccines and other biologic therapies, which may benefit patients with malignant melanoma.

Topoisomerase II‐alpha expression in melanocytic nevi and malignant melanoma

“…In general, chemotherapeutic regimens have not been successful in the treatment of disseminated MM and the factors involved in the chemoresistance of MM have not been elucidated. 21,24,36,37 Understanding of the cellular mechanisms mediating such chemoresistance may hold key to the future breakthrough in the management of advanced MM. Topo IIa is a proven cellular target for a variety of chemotherapeutic agents, including etoposide, mitoxantrone, teniposide, and doxorubicin.…”

Extensive malignant melanoma of the oral cavity: a rare occurrence

“…Although surgical excision is considered a curative option for early lesions of malignant melanoma, patients with extensive disease can be subjected to adjuvant chemoradiation/ immunotherapy, despite poor radiosensitive tumor. 20 In the present case, the patient was subjected to adjuvant radiotherapy due to extensive disease, although we did not get any locoregional/systemic metastasis in the final histopathological report. In recent years, immune therapy has been considered for better survival of patients with malignant mucosal melanoma.…”

Radiation-Induced Cell Cycle Delays and p53 Status of Early Passage Melanoma Cell Lines

“…apy (23). However, melanoma, in spite of a high incidence of wild-type TP53 gene status, is known for its Functional studies have shown that radiation-induced cell cycle arrest in G 1 phase, although clearly evident in chemoresistance (24). One possible reason for this discrepancy is that the function of p53 protein in melanoma most of the cell lines with wild-type TP53 status, is variable and transitory.…”