Burden Of Malignant Melanoma Research Articles

Burden of malignant melanoma in Ukraine in 2002-2013: incidence, mortality and survival.

The malignant melanoma (MM) incidence rates were increasing and later stabilizing in many regions of the world, while in South-Eastern Europe incidence rates are uniformly increasing and mortality rates are higher. To describe burden of MM in Ukraine in terms of incidence, mortality and survival by sex, age and stage for the period 2002-2013and compare with European countries. Database of the National Cancer Registry of Ukraine was used to extract MM incidence cases; number of MM deaths was obtained from the official mortality statistics. Age-standardised and age-specific incidence and mortality rates were calculated by sex, age groups (15-39, 40-59and 60+); estimated annual percent of change was used to describe trends. Proportions of new cases by stage of disease and calendar period (2002-2007vs 2008-2013) were compared as well as net survival estimates. In Ukraine, MM was more common in females (age-standardised 5.3per 100,000in 2013; annual percent of change 3.5%) than in males (5.1per 100,000; 4.1%); around 50% of them diagnosed in the age group 60+. The observed increase in proportion of new cases with early stage (I-II) was due to stage II cases. The slight increase in mortality rates in males or stability in females were not accompanied with increase of survival. Net MM survival was consistently lower comparing to European countries. More resources should be targeted to increase the capacity of healthcare in diagnostics and treatment of malignant melanoma, but also in promoting healthcare and education in Ukraine.

Abstract 1409: Is it what's on the inside that counts? Melanoma mutation profiling and outcomes with immunotherapy

Abstract Extraordinary advances have been made in the treatment of melanoma over the last few years; immune checkpoint blockade has provided durable responses and meaningful survival outcomes for patients with metastatic disease, yet predicting such responses remains a nascent science. More importantly, the toxicity and financial burden of receiving such therapy warrants a personalized, or precision medicine, approach to appropriate selection of treatment, thus molecular predictors of response may become as important as biomarkers such as PDL1 expression. Recently the high mutational burden of malignant melanoma was shown to be related to the degree of response to the anti-CTLA4 antibody ipilimumab, but mutational burden alone was not sufficient to predict benefit1. Another study has shown NRAS-mutant had a trend to superior outcomes compared with other cohorts in terms of response to therapy with anti-PD1 antibodies and progression-free survival2. Moreover, insight into the molecular evolution of melanoma was recently established3, wherein somatic mutations in oncogenes such as BRAF, NRAS, GNAQ, or GNA11 occur early during progression and additional mutations of TERT, CDKN2A, TP53, and PTEN are seen in late-stage disease. To better evaluate the relationship of these mutations to immunotherapy response, our institution has profiled 95 patients with melanoma with next-generation sequencing (NGS). Of the 95 patients profiled, the most common mutations identified were BRAF (38%), NRAS (21%), TP53 (18%), PTEN (14%), TERT (9%), and CDKN2A (8%). We are presently conducting a retrospective analysis of these selected oncogenes as they relate to clinical responses, and intend to report disease outcomes (duration of response, progression free survival, and overall survival) as they relate to checkpoint inhibition. Citation Format: Morganna L. Freeman, Howard McLeod. Is it what's on the inside that counts? Melanoma mutation profiling and outcomes with immunotherapy. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1409.

The burden of malignant melanoma – Lessons to be learned from Austria

Aim of studyIncidence rates of melanoma, generated by cancer registries (CRs), are susceptible to reporting inconsistencies due to increasing decentralisation of diagnosis. We therefore independently assessed the burden of melanoma in Austria. MethodsWe collected histopathological reports on melanoma of all patients diagnosed in Austria in 2011. Demographic and clinical characteristics, histopathological tumour stages were assessed. Their regional distributions and incidence rates were analysed and compared with data of national and international CRs. ResultsA total of 5246 patients were diagnosed with 1951 in-situ and 3295 invasive melanomas in Austria in 2011 (population 8.4 million). Age, sex and anatomic distribution corresponded to findings in other European countries, however, the incidence of 25/100,000 (world age-standardised rate) for invasive melanomas was two-fold higher than published by the Austrian CR (12/100,000). Varying frequencies in diagnosing thin melanomas (≤1 mm; n = 4415) accounted exclusively for significant regional disparities, while advanced tumours (>1 mm; n = 761) were evenly distributed. Western Austria showed the highest rates (36/100,000). Patients from eastern Austria whose melanomas were diagnosed in laboratories in western Austria (n = 76) showed significantly higher proportions of in-situ lesions (n = 43; 57%) compared to those whose tumours were diagnosed in eastern Austria (n = 4014; in-situ = 1369; 34%) (p < 0.0001). ConclusionsIn Austria, the melanoma burden and its potential socio-economic implications are significantly underestimated. Similarities of incidences indicate this could affect other European countries with well-established CRs and compromise international comparability of data. Austrian regional disparities suggest overdiagnosis of thin melanomas due to the variability of pathologists' thresholds for the diagnosis of early stage tumours.