Treatment of Genital Melanoma: Are We Ready for Innovative Therapies?

Ditto, Antonino; Bogani, Giorgio; Martinelli, Fabio; Raspagliesi, Francesco

doi:10.1097/igc.0000000000001018

Cited by 3 publications

(2 citation statements)

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“…Only a few papers reported outcomes of early stage disease with discordant results [2023]. Surgery represents the mainstay of treatment for early stage genital melanoma [2024]. In fact, there is still no consensus on the use of adjuvant therapy and only a single case series and few case reports on this topic are available [161725].…”

Section: Discussionmentioning

confidence: 99%

Investigating the role of immunotherapy in advanced/recurrent female genital tract melanoma: a preliminary experience

et al. 2019

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Objectiveimmunotherapy with immune checkpoint inhibitors has become one of the standard therapeutic modalities for patients with advanced melanoma. Melanoma of the female lower genital tract is a rare and aggressive disease, with poor long-term clinical outcomes. To date, no study evaluated the role of immunotherapy in metastatic melanoma of the lower genital tract.MethodsData of women with metastatic melanoma of the lower genital tract were prospectively collected. Survival outcomes over time was assessed using Kaplan-Meier model.ResultsSeven cases of metastatic melanoma of the lower genital tract (vulva [n=2], vagina [n=4], and uterine cervix [n=1]) treated with immune checkpoint inhibitors are reviewed. Two patients had metastatic disease at diagnosis, while 5 patients developed metastatic disease at a mean (standard deviation) time of 9.9 (±3.0) months from primary diagnosis. Four patients received an anti-cytotoxic T lymphocyte-associated antigen 4 (CTLA4) (ipilimumab) and 3 received an anti-programmed cell death 1 (PD-1) (pembrolizumab [n=2], nivolumab [n=1]) therapy. The response rate to immunotherapy was 28.5%. Patients receiving an anti-PD-1 experienced a better progression-free survival than patients treated with anti-CTLA4 (p=0.01, log-rank test). Although not reaching statistical significance, overall survival was better in patients having an anti-PD-1 therapy in comparison to anti-CTLA4 (p=0.15, log-rank test).ConclusionResults from our series confirm the poor prognosis of women with metastatic melanoma of the lower genital tract, thus supporting the need of exploring new treatment modalities. Further studies are warranted to improve knowledge on the role of immunotherapy in metastatic melanoma of the lower genital tract.

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Section: Discussionmentioning

confidence: 99%

Investigating the role of immunotherapy in advanced/recurrent female genital tract melanoma: a preliminary experience

et al. 2019

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“…Patients with MOGS frequently present at an advanced disease stage due to their internal location. Pelvic and/or inguinal nodal involvement is an important prognostic factor and is reported in 25 to 50% of cases [10][11][12]. Surgical excision can be challenging given the proximity of affected tissues to anatomic structures of importance, such as the rectum and bladder [6,8,13].…”

Section: Introductionmentioning

confidence: 99%

Expression of microRNAs and their target genes in melanomas originating from gynecologic sites

et al. 2023

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Melanomas from gynecologic sites (MOGS) are rare and have poor survival. MicroRNAs (miRs) regulate gene expression and are dysregulated in cancer. We hypothesized that MOGS would display unique miR and mRNA expression profiles. The miR and mRNA expression profile in RNA from formalin fixed, paraffin embedded vaginal melanomas (relative to vaginal mucosa) and vulvar melanomas (relative to cutaneous melanoma) were measured with the Nanostring Human miRNA assay and Tumor Signaling mRNA assay. Differential patterns of expression were identified for 21 miRs in vaginal and 47 miRs in vulvar melanoma (fold change >2, p<0.01). In vaginal melanoma, miR-145-5p (tumor suppressor targeting TLR4, NRAS) was downregulated and miR-106a-5p, miR-17-5p, miR-20b-5p (members of miR-17-92 cluster) were upregulated. In vulvar melanoma, known tumor suppressors miR-200b-3p and miR-200a-3p were downregulated, and miR-20a-5p and miR-19b-3p, from the miR-17-92 cluster, were upregulated. Pathway analysis showed an enrichment of “proteoglycans in cancer”. Among differentially expressed mRNAs, topoisomerase IIα (TOP2A) was upregulated in both MOGS. Gene targets of dysregulated miRs were identified using publicly available databases and Pearson correlations. In vaginal melanoma, suppressor of cytokine signaling 3 (SOCS3) was downregulated, was a validated target of miR-19b-3p and miR-20a-5p and trended toward a significant inverse Pearson correlation with miR-19b-3p (p = 0.093). In vulvar melanoma, cyclin dependent kinase inhibitor 1A (CDKN1A) was downregulated, was the validated target of 22 upregulated miRs, and had a significant inverse Pearson correlation with miR-503-5p, miR-130a-3p, and miR-20a-5p (0.005 < p < 0.026). These findings support microRNAs as mediators of gene expression in MOGS.

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Predictive biomarkers and tumor microenvironment in female genital melanomas: a multi-institutional study of 55 cases

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Lee

et al. 2020

Modern Pathology

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Treatment of Genital Melanoma: Are We Ready for Innovative Therapies?

Cited by 3 publications

References 5 publications

Investigating the role of immunotherapy in advanced/recurrent female genital tract melanoma: a preliminary experience

Investigating the role of immunotherapy in advanced/recurrent female genital tract melanoma: a preliminary experience

Expression of microRNAs and their target genes in melanomas originating from gynecologic sites

Predictive biomarkers and tumor microenvironment in female genital melanomas: a multi-institutional study of 55 cases

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