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stage IV melanoma

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https://www.readbyqxmd.com/read/28221865/cost-effectiveness-of-immune-checkpoint-inhibition-in-braf-wild-type-advanced-melanoma
#1
Christine G Kohn, Simon B Zeichner, Qiushi Chen, Alberto J Montero, Daniel A Goldstein, Christopher R Flowers
Purpose Patients who are diagnosed with stage IV metastatic melanoma have an estimated 5-year relative survival rate of only 17%. Randomized controlled trials of recent US Food and Drug Administration-approved immune checkpoint inhibitors-pembrolizumab (PEM), nivolumab (NIVO), and ipilumumab (IPI)-demonstrate improved patient outcomes, but the optimal treatment sequence in patients with BRAF wild-type metastatic melanoma remains unclear. To inform policy makers about the value of these treatments, we developed a Markov model to compare the cost-effectiveness of different strategies for sequencing novel agents for the treatment of advanced melanoma...
February 21, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28206940/resection-of-gastrointestinal-metastases-in-stage-iv-melanoma-correlation-with-outcomes
#2
Sangeetha Prabhakaran, William J Fulp, Ricardo J Gonzalez, Vernon K Sondak, Ragini R Kudchadkar, Geoffrey T Gibney, Jeffrey S Weber, Jonathan S Zager
The prognosis of patients with gastrointestinal (GI) melanoma metastases is poor. Surgery renders select patients disease free and/or palliates symptoms. We reviewed our single-institution experience of resection with GI melanoma metastases. A retrospective review was performed on patients who underwent surgery for GI melanoma metastases from 2007 to 2013. Fifty-four patients were identified and separated based on completeness of resection into curative 13 (24%) and palliative 41 (75.9%) groups. Thiry-six (63...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28193627/adoptive-transfer-of-invariant-nkt-cells-as-immunotherapy-for-advanced-melanoma-a-phase-1-clinical-trial
#3
Mark A Exley, Philip Friedlander, Nadia Alatrakchi, Lianne Vriend, Simon C Yue, Tetsuro Sasada, Wanyong Zang, Yo Mizukami, Justice Clark, David Nemer, Ken LeClair, Christine Canning, Heather Daley, Glenn Dranoff, Anita Giobbie-Hurder, F Stephen Hodi, Jerome Ritz, Steven P Balk
PURPOSE: Invariant NKT cells (iNKT) are innate-like CD1d-restricted T cells with immunoregulatory activity in diseases including cancer. iNKT from advanced cancer patients can have reversible defects including IFNγ production, and iNKT IFNγ production may stratify for survival. Previous clinical trials using iNKT cell activating ligand α-galactosylceramide have shown responses. Therefore, a phase 1 clinical trial was performed of autologous in vitro expanded iNKT cells in stage IIIB-IV melanoma...
February 13, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28188500/isolated-limb-perfusion-for-melanoma-is-safe-and-effective-in-elderly-patients
#4
Max F Madu, Marion M Deken, Jos A van der Hage, Katarzyna Jóźwiak, Michel W J M Wouters, Alexander C J van Akkooi
BACKGROUND: Data on isolated limb perfusion (ILP) in elderly melanoma patients are scarce. We aimed to evaluate the efficacy and safety of ILP in our institutional cohort of melanoma patients. METHODS: We performed retrospective analysis of stage IIIB/C melanoma patients who underwent ILP for melanoma in-transit metastases (ITMs) in our institution between 2000 and 2016. Normothermic ILP was performed with either melphalan or melphalan and tumor necrosis factor...
February 10, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28167454/peripheral-cd8-effector-memory-type-1-t-cells-correlate-with-outcome-in-ipilimumab-treated-stage-iv-melanoma-patients
#5
Kilian Wistuba-Hamprecht, Alexander Martens, Florian Heubach, Emanuela Romano, Marnix Geukes Foppen, Jianda Yuan, Michael Postow, Phillip Wong, Domenico Mallardo, Bastian Schilling, Anna Maria Di Giacomo, Amir Khammari, Brigitte Dreno, Michele Maio, Dirk Schadendorf, Paolo A Ascierto, Jedd D Wolchok, Christian U Blank, Claus Garbe, Graham Pawelec, Benjamin Weide
The role of the assessment of peripheral T-cell phenotypes in predicting overall survival (OS) after ipilimumab treatment is unclear. Here, we analysed mononuclear cells in the blood before and at different time points during treatment with ipilimumab in 137 late-stage melanoma patients. The proportions of baseline naïve and memory T-cells were measured by flow cytometry and correlated with OS, with an emphasis on PD-1 expression. High frequencies (>13%) of CD8 effector-memory type 1 (EM1) T-cells at baseline correlated with longer OS (p = 0...
March 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28144760/routine-computer-tomography-imaging-for-the-detection-of-recurrences-in-high-risk-melanoma-patients
#6
Tristen S Park, Giao Q Phan, James C Yang, Udai Kammula, Marybeth S Hughes, Kasia Trebska-McGowan, Kathleen E Morton, Donald E White, Steven A Rosenberg, Richard M Sherry
BACKGROUND: The use of routine CT imaging for surveillance in asymptomatic patients with cutaneous melanoma is controversial. We report our experience using a surveillance strategy that included CT imaging for a cohort of patients with high-risk melanoma. METHODS: A total of 466 patients with high-risk cutaneous melanoma enrolled in adjuvant immunotherapy trials were followed for tumor progression by physical examination, labs, and CT imaging as defined by protocol...
January 31, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28135150/phase-iii-randomized-study-of-4-weeks-of-high-dose-interferon-%C3%AE-2b-in-stage-t2bno-t3a-bno-t4a-bno-and-t1-4n1a-2a-microscopic-melanoma-a-trial-of-the-eastern-cooperative-oncology-group-american-college-of-radiology-imaging-network-cancer-research-group-e1697
#7
Sanjiv S Agarwala, Sandra J Lee, Waiki Yip, Uma N Rao, Ahmad A Tarhini, Gary I Cohen, Douglas S Reintgen, Terry L Evans, Joanna M Brell, Mark R Albertini, Michael B Atkins, Shaker R Dakhil, Robert M Conry, Jeffrey A Sosman, Lawrence E Flaherty, Vernon K Sondak, William E Carson, Michael G Smylie, Alberto S Pappo, Richard F Kefford, John M Kirkwood
Purpose To test the efficacy of 4 weeks of intravenous (IV) induction with high-dose interferon (IFN) as part of the Eastern Cooperative Oncology Group regimen compared with observation (OBS) in patients with surgically resected intermediate-risk melanoma. Patients and Methods In this intergroup international trial, eligible patients had surgically resected cutaneous melanoma in the following categories: (1) T2bN0, (2) T3a-bN0, (3) T4a-bN0, and (4) T1-4N1a-2a (microscopic). Patients were randomly assigned to receive IFN α-2b at 20 MU/m(2)/d IV for 5 days (Monday to Friday) every week for 4 weeks (IFN) or OBS...
January 30, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28132115/rictor-expression-in-esophageal-squamous-cell-carcinoma-and-its-clinical-significance
#8
Wei-Jia Jiang, Ru-Xue Feng, Jia-Tao Liu, Lu-Lu Fan, Hua Wang, Guo-Ping Sun
Esophageal cancer is one of the most common malignant tumors in the world, and its incidence is the eighth highest; meanwhile, its fatality rate is the sixth highest. The PI3K/Akt/mTOR signaling pathway plays a required role in human cancer, including cell survival, metabolism and migration. As a kind of important scaffold protein in mTORC2, RICTOR has showed over-expression in several malignancies like melanoma and endometrial cancer. In this research, we selected 201 cases of paraffin specimens from patients diagnosed as esophageal squamous cell carcinoma after surgical treatment and then estimated the RICTOR expression in each esophageal squamous cell carcinoma tissue by using the immunohistochemical streptavidin-peroxidase technique...
March 2017: Medical Oncology
https://www.readbyqxmd.com/read/28125448/basal-neutrophil-to-lymphocyte-ratio-is-associated-with-overall-survival-in-melanoma
#9
Leonardo S Lino-Silva, Rosa A Salcedo-Hernández, Leticia García-Pérez, Abelardo Meneses-García, César Zepeda-Najar
Several studies have reported that a high neutrophil-to-lymphocyte ratio (NLR) is associated with poor clinical outcomes in several cancers, but this ratio has not been thoroughly studied in melanoma except in stage IV. This is the first study on NLR in melanoma stages I-III. This was a retrospective study of 742 melanoma patients. The NLR was classified into NLR<2 and a NLR≥2 on the basis of a receiver operating characteristic curve. Associations of NLR with clinicopathological characteristics and survival were examined...
January 25, 2017: Melanoma Research
https://www.readbyqxmd.com/read/28114257/clinical-trial-design-and-endpoints-for-stage-iv-melanoma-in-the-modern-era
#10
Benjamin Izar, Meredith M Regan, David F McDermott
Immunotherapies and targeted therapies for the treatment of metastatic or advanced melanoma produce unique patterns of antitumor response. Conventional outcome measures, such as median progression-free and overall survival, may not be ideally suited to identify all patients who derive a benefit from such therapies. Therefore, the introduction of additional endpoint measures, such as milestone comparisons, may be necessary to characterize the potential benefit of such treatment approaches. Immune checkpoint inhibitors induce durable responses in a portion of patients that may continue after treatment cessation...
January 2017: Cancer Journal
https://www.readbyqxmd.com/read/28099365/melanoma-during-pregnancy-a-report-of-60-pregnancies-complicated-by-melanoma
#11
Jorine de Haan, Christianne A Lok, Christianne J de Groot, Marianne B Crijns, Kristel Van Calsteren, Karina Dahl Steffensen, Michael J Halaska, Sevilay Altintas, Ingrid A Boere, Robert Fruscio, Wojciech Kolawa, Petronella O Witteveen, Frédéric Amant
The management of melanoma during pregnancy is challenging as maternal benefits and fetal risks need to be balanced. Here, we present an overview of the incidence, the demographic and clinical characteristics and the treatment modalities used. After analysis of obstetric, fetal and maternal outcome, recommendations for clinical practice are provided. From the 'International Network on Cancer, Infertility and Pregnancy' database, pregnant patients with melanoma were identified and analysed. Sixty pregnancies were eligible for analysis...
January 17, 2017: Melanoma Research
https://www.readbyqxmd.com/read/28094857/use-of-oncept-melanoma-vaccine-in-69-canine-oral-malignant-melanomas-in-the-uk
#12
S Verganti, D Berlato, L Blackwood, I Amores-Fuster, G A Polton, R Elders, R Doyle, A Taylor, S Murphy
OBJECTIVES: Oral malignant melanomas carry a poor-to-guarded prognosis because of their local invasiveness and high metastatic propensity. The Oncept melanoma vaccine is licensed to treat dogs with stage II or III locally-controlled oral malignant melanoma and this retrospective study aimed to assess survival of affected dogs treated with the vaccine in the UK. MATERIAL AND METHODS: Medical records of dogs with histopathologically-confirmed oral malignant melanoma that received the vaccine as part of their treatment were evaluated...
January 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28091975/update-on-advanced-melanoma-treatments-small-molecule-targeted-therapy-immunotherapy-and-future-combination-therapies
#13
Andrew Kwong, Martina Sanlorenzo, Klemens Rappersberger, Igor Vujic
Early stage melanomas can achieve remarkable outcomes with surgery alone, but stage IV metastatic melanoma requires significant intervention and has poor outcomes. Here we present evidence on the latest advances in melanoma treatment, discuss the scientific concepts behind new therapies, and analyze the potential of future treatment combinations.
January 13, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28078357/intralesional-treatment-of-metastatic-melanoma-a-review-of-therapeutic-options
#14
REVIEW
Benjamin Weide, Dario Neri, Giuliano Elia
Intralesional therapy of melanoma patients with locally advanced metastatic disease is attracting increasing interest, not least due to its ability to lead to both direct tumor cell killing and the stimulation of both a local and a systemic immune response. An obvious pre-requisite for this type of approach is the presence of accessible metastases that are amenable to direct injection with the therapeutic agent of interest. Patients who present with these characteristics belong to stages IIIB/C or IV of the disease...
January 11, 2017: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/28073773/long-term-survival-and-clinical-benefit-from-adoptive-t-cell-transfer-in-stage-iv-melanoma-patients-is-determined-by-a-four-parameter-tumor-immune-signature
#15
Sara M Melief, Valeria V Visconti, Marten Visser, Merel van Diepen, Ellen H W Kapiteijn, Joost H van den Berg, John B A G Haanen, Vincent T H B M Smit, Jan Oosting, Sjoerd H van der Burg, Els M E Verdegaal
The presence of tumor-infiltrating immune cells is associated with longer survival and a better response to immunotherapy in early-stage melanoma, but a comprehensive study of the in situ immune microenvironment in stage IV melanoma has not been performed. We investigated the combined influence of a series of immune factors on survival and response to adoptive cell transfer (ACT) in stage IV melanoma patients. Metastases of 73 stage IV melanoma patients, 17 of which were treated with ACT, were studied with respect to the number and functional phenotype of lymphocytes and myeloid cells as well as for expression of galectins-1, -3, and -9...
January 10, 2017: Cancer Immunology Research
https://www.readbyqxmd.com/read/28059663/the-effect-of-timing-of-stereotactic-radiosurgery-treatment-of-melanoma-brain-metastases-treated-with-ipilimumab
#16
Or Cohen-Inbar, Han-Hsun Shih, Zhiyuan Xu, David Schlesinger, Jason P Sheehan
OBJECTIVE Melanoma represents the third most common cause of CNS metastases. Immunotherapy has evolved as a treatment option for patients with Stage IV melanoma. Stereotactic radiosurgery (SRS) also elicits an immune response within the brain and may interact with immunotherapy. The authors report on a cohort of patients treated for brain metastases with immunotherapy and evaluate the effect of SRS timing on the intracranial response. METHODS All consecutively treated melanoma patients receiving ipilimumab and SRS for treatment of brain metastases at the University of Virginia between 2009 and 2014 were included in this retrospective analysis; data from 46 patients harboring 232 brain metastases were reviewed...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28046326/su-f-t-568-qa-of-a-multi-target-multi-dose-vmat-srs
#17
D Roa, A Gonzales, J Kuo
PURPOSE: To, experimentally, corroborated the prescribed doses utilizing dosimeters (e.g. films and TLDs) that can provide high spatial resolution, allow dose measurement of multiple targets at once, and provide accurate dosimetric results. METHODS: A single-isocenter 6FFF SRS VMAT plan consisting of one 358° arc at 0° couch angle and four 179° arcs at 30°, 60°, 330° and 300° couch angles respectively, was generated in ECLIPSE v.11 using a Rando-Alderson anthropomorphic head phantom CT study...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045747/next-generation-sequencing-reveals-pathway-activations-and-new-routes-to-targeted-therapies-in-cutaneous-metastatic-melanoma
#18
J Andrew Carlson, Jose Candido Caldeira Xavier, Ashley Tarasen, Christine E Sheehan, Geoff Otto, Vincent A Miller, Philip J Stephens, Julia A Elvin, Jo-Anne Vergilio, James Suh, Laurie M Gay, Jeffrey S Ross
BACKGROUND: Comprehensive genomic profiling of clinical samples by next-generation sequencing (NGS) can identify one or more therapy targets for the treatment of metastatic melanoma (MM) with a single diagnostic test. METHODS: NGS was performed on hybridization-captured, adaptor ligation-based libraries using DNA extracted from 4 formalin-fixed paraffin-embedded sections cut at 10 microns from 30 MM cases. The exons of 182 cancer-related genes were fully sequenced using the Illumina HiSeq 2000 at an average sequencing depth of 1098X and evaluated for genomic alterations (GAs) including point mutations, insertions, deletions, copy number alterations, and select gene fusions/rearrangements...
January 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28039178/the-natural-history-and-patterns-of-metastases-from-mucosal-melanoma-an-analysis-of-706-prospectively-followed-patients
#19
B Lian, C L Cui, L Zhou, X Song, X S Zhang, D Wu, L Si, Z H Chi, X N Sheng, L L Mao, X Wang, B X Tang, X Q Yan, Y Kong, J Dai, S M Li, X Bai, N Zheng, Charles M Balch, J Guo
BACKGROUND: We examined whether mucosal melanomas are different in their clinical course and patterns of metastases when arising from different anatomic sites. Our hypothesis was that metastatic behavior would differ from primary mucosal melanomas at different anatomical sites. PATIENTS AND METHODS: Clinical and pathological data from 706 patients were compared for their stage distribution, patterns of metastases, CKIT/BRAF mutation status, and overall survival for different anatomical sites...
December 29, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28036288/vitamin-d-deficiency-is-associated-with-a-worse-prognosis-in-metastatic-melanoma
#20
Dmitriy Timerman, Melissa McEnery-Stonelake, Cara J Joyce, Vinod E Nambudiri, F Stephen Hodi, Elizabeth B Claus, Nageatte Ibrahim, Jennifer Y Lin
Vitamin D deficiency (≤20 ng/mL) is associated with an increased incidence and worse prognosis of various types of cancer including melanoma. A retrospective, single-center study of individuals diagnosed with melanoma from January 2007 through June 2013 who had a vitamin D (25(OH)D3) level measured within one year of diagnosis was performed to determine whether vitamin D deficiency and repletion are associated with melanoma outcome. A total of 409 individuals diagnosed with histopathology-confirmed melanoma who had an ever measured serum 25(OH)D3 level were identified...
January 24, 2017: Oncotarget
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