Melanoma medical therapy: Difference between revisions

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Latest revision as of 12:57, 11 July 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Serge Korjian M.D.; Yazan Daaboul, M.D.

Overview

Chemotherapy is indicated for high risk melanomas (stages IIB-IV) as adjuvant therapy and for metastatic disease as first-line therapy. Several single agent and combination regimens have been studied, all with modest impact on survival. All current guidelines still recommend enrollment in clinical trials over current available regimens for patients with metastatic disease. Interferon therapy is the only regimen recommended for adjuvant therapy.

Medical Therapy

Surgery is the predominant therapy for melanoma.a

Chemotherapy regimens

Adjuvant therapy^[1]

Interferon alfa-2a (Roferon-A)
Interferon alfa-2b (Intron-A)
Peginterferon alfa-2b (Sylatron)

Metastatic or unresectable melanoma^[1]
Either a single agent chemotherapy OR a combination chemotherapy is recommended for metastatic or unresectable melanoma.

Single Agent Chemotherapy

Dabrafenib (Tafinlar)
Dacarbazine (DTIC)
Docetaxel (Taxotere)
Interleukin-2 (high dose or maintenance biotherapy)
Imatinib (Gleevec)
Ipilimumab (Yervoy)
Nivolumab (Opdivo)
Paclitaxel (Taxol)
Pembrolizumab (Keytruda)
Temozolomide (Temodar)
Trametinib (Mekinist)
Vemurafenib (Zelboraf)

Combination Chemotherapy

Paclitaxel nanoparticle albumin-bound + Bevacizumab + Carboplatin (ABC)
Carboplatin + Paclitaxel
Carboplatin + Paclitaxel + nanoparticle albumin-bound
Carboplatin + Paclitaxel +, Sorafenib
Cisplatin + Dacarbazine ± Carmustine
Cisplatin + Dacarbazine + IL-2 + IFN alfa-2b ± Carmustine
Cisplatin + Paclitaxel + Dacarbazine
Cisplatin + Vinblastine + Dacarbazine
Cisplatin + Vinblastine + Dacarbazine + IL-2 + IFN alfa-2b (sequential biochemotherapy)
Temozolomide + Bevacizumab
Dabrafenib + Trametinib
Ipilimumab + Dacarbazine
Ipilimumab + Nivolumab
Binimetinib + Encorafenib

References

↑ ^1.0 ^1.1 Peter Yang and Jeremy Warner. Melanoma. Hemonc.org. Accessed on August 21, 2015. http://hemonc.org/wiki/Melanoma

[hemonc-1] 1.0 ^1.1 Peter Yang and Jeremy Warner. Melanoma. Hemonc.org. Accessed on August 21, 2015. http://hemonc.org/wiki/Melanoma

[1]

@@ Line 4: / Line 4: @@
 ==Overview==
-Chemotherapy is indicated for high risk melanomas (stages > IIA) as adjuvant therapy and for metastatic disease as first-line therapy. Several single agent and combination regimens have been studied, all with modest impact on survival. All current guidelines still recommend enrollment in clinical trials over current available regimens for patients with metastatic disease. Interferon therapy is the only regimen recommended for adjuvant therapy.
+Chemotherapy is indicated for high risk melanomas (stages IIB-IV) as adjuvant therapy and for metastatic disease as first-line therapy. Several single agent and combination regimens have been studied, all with modest impact on survival. All current guidelines still recommend enrollment in clinical trials over current available regimens for patients with metastatic disease. Interferon therapy is the only regimen recommended for adjuvant therapy.
 ==Medical Therapy==
-*Surgery is the predominant therapy for melanoma. Chemotherapy, however, is indicated for the following patient subgroups:
+*Surgery is the predominant therapy for melanoma.a
-:*Patients with high risk melanomas (Stage IIB-IV) - Adjuvant therapy using interferon therapy
-:*Patients with metastatic disease - First-line therapy using either a single agent or combination regimen.
-*Several single agent and combination regimens have been studied, all with modest impact on survival.
-*All current guidelines still recommend enrollment in clinical trials over current available regimens for patients with metastatic disease. Below is a summary of available adjuvant and treatment regimens.
 ===Chemotherapy regimens===
@@ Line 49: / Line 45: @@
 ::# [[Ipilimumab]] + [[Dacarbazine]]
 ::# [[Ipilimumab]] + [[Nivolumab]]
+::# [[Binimetinib]] + [[Encorafenib]]
 ==References==
 {{Reflist|2}}
+ [[Category:Up-To-Date]]
+[[Category:Oncology]]
+[[Category:Medicine]]
+[[Category:Dermatology]]
+[[Category:Surgery]]