Treatment Of Skin Melanoma Research Articles

The repeated treatment of targeted therapy in the treatment of skin melanoma

Currently, patients with disseminated forms of skin melanoma have limited treatment options. The most effective treatments, according to research, are targeted drugs BRAF/MEK inhibitors when a mutation in exon 15 of the BRAF gene is detected in tumor biopsy tissue and immune synapse modulators, specifically anti-CTLA-4 and anti-PD-1 drugs. Both classes of drugs show a significant benefit in overall and progression-free survival, but convincing data on their effectiveness in second and subsequent lines of therapy are still lacking. Most often, with the progression of disseminated skin melanoma during tyrosine kinase inhibitor therapy, a dual immunotherapy combination is used. In the event of further progression, due to the limited treatment options, clinical oncologists face questions about the possibility of returning to targeted therapy, changing tyrosine kinase inhibitor drugs, or using the initial combination, and their impact on progression-free survival in choosing treatment strategies for such patients, as well as the potential use of BRAF/MEK inhibitors. Assessing the reuse of tyrosine kinase inhibitor drugs is a highly relevant issue in clinical oncology.

The role of immunotherapy in the treatment of skin melanoma: a contemporary perspective

Purpose of the study. To evaluate the role and possibilities of various types of immunotherapy in the treatment of skin melanoma, as well as the prospects for its use in clinical practice.Materials and methods. The literature was looked up in the PubMed database. Publication date limit was set from 2018 to 2023. The following keywords were used as search queries: "Melanoma", "Melanoma and immunotherapy", "Treatment of Metastatic Melanoma", "Immunological Factors". Full-text versions were selected. Articles that were based on the subjective opinion of the authors were excluded from the study. For each research found, the following parameters were recorded: treatment method, number of patients, follow-up period, time of relapse-free course, survival rate. No meta-analysis of the data was performed due to the high heterogeneity of the studies. Results. A sufficiently high efficiency of adjuvant therapy with inhibitors of immune response control points in the treatment of BRAF-negative patients has been noted. For this reason, the drug ipilimumab, which appeared among the first, demonstrated its effectiveness. The drug nivolumab gave, according to one of the studies, a 5‑year overall survival rate of 35 %. The use of pembrolizumab was associated with a 5‑year overall survival rate of 41 %. In the 2015 meta-analysis It has been demonstrated that the use of nivolumab, as well as pembrolizumab, provides the best overall survival, and therefore can be included in first-line therapy. The combination of these drugs makes it possible to achieve a good response to therapy in patients with BRAF-positive status (5‑year overall survival rate of 52 %).Conclusion. Melanoma immunotherapy with immune response checkpoint inhibitors is currently the most effective treatment method, especially in cases where it complements surgical resection of the tumor. The most commonly used drugs are nivolumab and ipilimumab, which work more effectively when combined. Thus, the 5‑year progression-free survival rate is 36 %, the overall survival rate is 52 %. Resistance to immunotherapy is an important problem of this type of treatment, the solution of which will help to improve the outcomes of control over the local cancer process and improve the response to therapy. It is possible to find a solution to this problem due to the fundamental study of the molecular biology of the tumor in terms of modeling tumor growth and tumor "escape" mechanisms.

Effects of modern antitumor drug therapy possibilities to skin melanoma on oncological and epidemiological indicators in the Krasnoyarsk region

BACKGROUND: Deevelopment of new diagnostics and treatment of malignant neoplasms methods increase their efficiency, and safety is one of the most urgent tasks of modern oncology. Currently, targeted and immunotherapy contributes to the treatment of malignant neoplasms. One of the examples is the treatment of skin melanoma.
 AIMS: This study aimed to investigate the influence of therapeutic tactics on epidemiological indicators in the morbidity of the skin melanoma.
 MATERIALS AND METHODS: The study used data of the Krasnoyarsk territory cancer-register.
 RESULTS: In the Krasnoyarsk territory from 2016 to 2020 registered 65,042 cases of malignant neoplasms, of which 30,532 cases (46.9%) reported among men and 34,510 cases (53.1%) among women. In the same period, registered 899 cases of skin melanoma, 343 cases among men (38.2%) and 556 cases among women (61.8%). The most important stage in the treatment of skin melanoma is the disease stage, because only favorable prognosis characteristic for early stages of the disease.
 CONCLUSIONS: Routine using modern antitumor drug therapy in everyday clinical practice has significantly changed the results of skin melanoma treatment.

Use of skin-fascial flaps on perforating vessels in the surgical treatment of skin melanoma

Purpose of the study. Improving the results of surgical treatment of melanoma of the skin of the extremities by using skin-fascial flaps on perforating vessels.Patients and methods. In 42 patients with limb skin melanoma T1–3N0M0, the closure of a skin defect was performed by islet flaps on perforating vessels. Perforating vessels of the donor zone were detected with an assessment of the blood supply of the flaps in the pre- and postoperative period using ultrasound and marking of perforants with adjustment of the preliminary marking of the flaps.Results. Permanent perforating vessels with a diameter of more than 1 mm were used. After excision of the tumor, on the opposite sides of the wound defect, taking into account the location of the perforating vessels, flaps were taken, with further mobilization by excision of the fiber and muscle fascia, they were separated from the underlying tissues while maintaining the integrity of the supply vessels. The circulatory state of the selected flaps was determined by skin color and capillary response to digital pressure. The flaps were displaced to the center, covered the area of the defect and sutured with single sutures, the edges of the donor wound were mobilized, sutured with single sutures until light tension appeared and sutured into the remaining wound defect. In the postoperative period, the determination of the parameters of the blood flow of perforating vessels showed the absence of hemodynamically significant violations of the blood flow during the movement of the flap. Transient ischemia of one of the oncoming flaps after surgery developed in 11.9%, marginal necrosis of the distal flap — in 7.1% of cases. A normotrophic scar was formed, with a width of not more than 0.3 cm, which aesthetically satisfied 92.8% of patients. Assessment of two-year relapse-free survival showed a complete absence of local relapses.Conclusion. The flaps vascularized by perforating vessels have high viability, are identical in color and texture to the skin of the recipient area, and the close proximity to the receiving area contributes to minimal deformation of the donor area, which increases the radicality of the operation, reduces the incidence of postoperative complications and improves аesthetic and functional results.

BH3 Only Proteins as Major Player in Treatment of Skin Melanoma

BH3 Only Proteins as Major Player in Treatment of Skin Melanoma

Circular Cryogenic Excision in Surgical Treatment of Skin Melanoma

Circular Cryogenic Excision in Surgical Treatment of Skin Melanoma

PLGA-loaded nanomedicines in melanoma treatment: Future prospect for efficient drug delivery

Current treatment methods for melanoma have some limitations such as less target-specific action, severe side effects and resistance to drugs. Significant progress has been made in exploring novel drug delivery systems based on suitable biochemical mechanisms using nanoparticles ranging from 10 to 400 nm for drug delivery and imaging, utilizing their enhanced penetration and retention properties. Poly-lactide-co-glycolide (PLGA), a copolymer of poly-lactic acid and poly-glycolic acid, provides an ideally suited performance-based design for better penetration into skin cells, thereby having a greater potential for the treatment of melanoma. Moreover, encapsulation protects the drug from deactivation by biological reactions and interactions with biomolecules, ensuring successful delivery and bioavailability for effective treatment. Controlled and sustained delivery of drugs across the skin barrier that otherwise prohibits entry of larger molecules can be successfully made with adequately stable biocompatible nanocarriers such as PLGA for taking drugs through the small cutaneous pores permitting targeted deposition and prolonged drug action. PLGA is now being extensively used in photodynamic therapy and targeted therapy through modulation of signal proteins and drug-DNA interactions. Recent advances made on these nanomedicines and their advantages in the treatment of skin melanoma are highlighted and discussed in this review.

Analiza utucaja lokalizacije tumora na kasnu dijagnozu i lečenje pacijenata sa melanom kože

With the prospective study, from June 2004 to June 2012, were compared the results of the influence of tumor position on late diagnosis and treatment of skin melanoma. Respondents were classified according to clinical appearance in 2 equal groups. The first group, group A (32 respondents) consisted of respondents that underwent radical wide excision of the primary tumor at an early stage of the disease. In the second group, group B (32 respondents) were classified respondents with melanoma that underwent radical excision of melanoma at a later stage of the disease. The aim of this study was to analyze the influence of tumor localization on late diagnosis and treatment of skin melanoma. In 25 respondents (78.1%) who were operated at an early stage, melanoma was located on the face, chest, abdomen and extremities, while in 7 (21.9%) respondents, melanoma was localized on the back. In the group of late operated respondents, melanoma was positioned on the face, chest, abdomen and extremities in 9 (28.1%) respondents, while in 23 (71.9%) respondents, tumor was localized on the back. It has been shown that tumor localization essentially determines the time of visits of respondents for examination. Melanoma on the back remains unnoticed for a long time, i.e. unrecognized changes in lesions compared to lesions of other anatomical regions, which is probably the reason for the bigger waste of time and late diagnosis. Respondents in group B consulted the doctor 4-5 months later, because of melanoma position than the group A, which is proved to be statistically significant. There was found a statistically significant difference in terms of recurrence of the disease. Relapse was observed in group B 3 times higher than in group A. Localization of melanoma significantly affects the outcome of the treatment of the disease. There was a statistically significant difference in survival of respondents in groups, because the mortality rate in group B was almost three times higher.

Treatment of skin melanoma with pulsed radiation from a neodymium laser

Pulsed radiation generated by powerful neodymium glass lasers was used to treat 272 cases of stage I skin melanomas; 250 patients (91.9%) patients were treated 5 years ago or earlier. Local recurrences of melanoma were detected in 2 (0.7%) cases within 1 to 8 years of followup. Regional metastases developed in 45 (16.5 63.3%) cases and distant ones in 12 (4.461.6%); 1 (0.4%) female patient presented with a transport metastasis. In patients treated 5 years ago or earlier, regional metastases occurred in 16.263.8% cases, distant ones in 4.461.6%, and transport ones in 0.4%. Five-year survival was registered in 84.562.8% of patients. Powerful pulsed laser radiation is effective in treating flat and slightly elevated skin melanomas that are up to 4.5 cm thick and that are characterized by levels I to IV of invasion.