Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Advances in Therapy
Published in: Advances in Therapy 9/2014

01-09-2014 | Review

Melanoma: Diagnosis, Staging, and Treatment. Consensus group recommendations

Authors: Alfonso Berrocal, Luis Cabañas, Enrique Espinosa, Ricardo Fernández-de-Misa, Salvador Martín-Algarra, José Carlos Martínez-Cedres, Luis Ríos-Buceta, José Luis Rodríguez-Peralto

Published in: Advances in Therapy | Issue 9/2014

Login to get access

Abstract

The incidence of malignant melanoma is increasing worldwide. In Spain, its incidence is increasing faster than any other cancer type, with a 5-year survival rate of about 85%. The impact and characteristics of malignant melanoma in the Spanish population can be ascertained from the national melanoma registry of the Academia Española de Dermatología y Venereología. This review presents consensus group recommendations for the diagnosis, staging and treatment of malignant melanoma in Spain. Incidence and mortality are discussed, as well as evaluation of various prevention and treatment strategies. Prognostic factors, such as BRAF and C-KIT mutations, which are expected to become routine staging procedures over the next few years, are outlined, especially in relation to treatment options. The use of recently approved targeted agents such as ipilimumab, a cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) inhibitor, and vemurafenib, a BRAF inhibitor, in metastatic disease are also discussed.
Appendix
Available only for authorised users
Literature
1.
Marcos-Gragera R, Vilar-Coromina N, Galceran J, et al. Rising trends in incidence of cutaneous malignant melanoma and their future projections in Catalonia, Spain: increasing impact or future epidemic? J Eur Acad Dermatol Venereol. 2010;24(9):1083–8.PubMed
2.
Saenz S, Conejo-Mir J, Cayuela A. Melanoma epidemiology in Spain. Actas Dermosifiliogr. 2005;96(7):411–8.PubMed
3.
Cabanes A, Vidal E, Aragones N, et al. Cancer mortality trends in Spain: 1980–2007. Ann Oncol. 2010;21 Suppl 3:iii14–20.
4.
Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893–917.PubMed
5.
Chirlaque MD, Salmeron D, Ardanaz E, et al. Cancer survival in Spain: estimate for nine major cancers. Ann Oncol. 2010:21 Suppl 3:iii21–29.
6.
Newton-Bishop JA, Chang YM, Elliott F, et al. Relationship between sun exposure and melanoma risk for tumours in different body sites in a large case–control study in a temperate climate. Eur J Cancer. 2011;47(5):732–41.PubMedPubMedCentral
7.
Newton-Bishop JA, Chang YM, Iles MM, et al. Melanocytic nevi, nevus genes, and melanoma risk in a large case–control study in the United Kingdom. Cancer Epidemiol Biomarkers Prev. 2010;19(8):2043–54.PubMedPubMedCentral
8.
Cho E, Rosner BA, Colditz GA. Risk factors for melanoma by body site. Cancer Epidemiol Biomarkers Prev. 2005;14(5):1241–4.PubMed
9.
Marghoob AA, Schoenbach SP, Kopf AW, et al. Large congenital melanocytic nevi and the risk for the development of malignant melanoma. A prospective study. Arch Dermatol. 1996;132(2):170–5.PubMed
10.
Marsden JR, Newton-Bishop JA, Burrows L, et al. Revised UK guidelines for the management of cutaneous melanoma 2010. Br J Dermatol. 2010;163(2):238–56.PubMed
11.
Naeyaert JM, Brochez L. Clinical practice. Dysplastic nevi. N Engl J Med. 2003;349(23):2233–40.PubMed
12.
Puig S, Malvehy J, Badenas C, et al. Role of the CDKN2A locus in patients with multiple primary melanomas. J Clin Oncol. 2005;23(13):3043–51.PubMed
13.
Chen GJ, Feldman SR, Williford PM, et al. Clinical diagnosis of actinic keratosis identifies an elderly population at high risk of developing skin cancer. Dermatol Surg. 2005;31(1):43–7.PubMed
14.
Troyanova P, Danon S, Ivanova T. Nonmelanoma skin cancers and risk of subsequent malignancies: a cancer registry-based study in Bulgaria. Neoplasma. 2002;49(2):81–5.PubMed
15.
Hollenbeak CS, Todd MM, Billingsley EM, et al. Increased incidence of melanoma in renal transplantation recipients. Cancer. 2005;104(9):1962–7.PubMed
16.
Montella M, Crispo A, Grimaldi M, et al. An assessment of factors related to tumor thickness and delay in diagnosis of melanoma in southern Italy. Prev Med. 2002;35(3):271–7.PubMed
17.
Green AC, Williams GM, Logan V, et al. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol. 2011;29(3):257–63.PubMed
18.
Durbec F, Vitry F, Granel-Brocard F, et al. The role of circumstances of diagnosis and access to dermatological care in early diagnosis of cutaneous melanoma: a population-based study in France. Arch Dermatol. 2010;146(3):240–6.PubMed
19.
Brady MS, Oliveria SA, Christos PJ, et al. Patterns of detection in patients with cutaneous melanoma. Cancer. 2000;89(2):342–7.PubMed
20.
Andersen WK, Silvers DN. ‘Melanoma? It can’t be melanoma!’ A subset of melanomas that defies clinical recognition. JAMA. 1991;266(24):3463–5.PubMed
21.
McPherson M, Elwood M, English DR, et al. Presentation and detection of invasive melanoma in a high-risk population. J Am Acad Dermatol. 2006;54(5):783–92.PubMed
22.
Schwartz JL, Wang TS, Hamilton TA, et al. Thin primary cutaneous melanomas: associated detection patterns, lesion characteristics, and patient characteristics. Cancer. 2002;95(7):1562–8.PubMed
23.
Tran KT, Wright NA, Cockerell CJ. Biopsy of the pigmented lesion—when and how. J Am Acad Dermatol. 2008;59(5):852–71.PubMed
24.
Nagore E, Botella-Estrada R, Requena C, et al. Clinical and epidemiologic profile of melanoma patients according to sun exposure of the tumor site. Actas Dermosifiliogr. 2009;100(3):205–11.PubMed
25.
Dolianitis C, Kelly J, Wolfe R, et al. Comparative performance of 4 dermoscopic algorithms by nonexperts for the diagnosis of melanocytic lesions. Arch Dermatol. 2005;141(8):1008–14.PubMed
26.
Carli P, Quercioli E, Sestini S, et al. Pattern analysis, not simplified algorithms, is the most reliable method for teaching dermoscopy for melanoma diagnosis to residents in dermatology. Br J Dermatol. 2003;148(5):981–4.PubMed
27.
Nachbar F, Stolz W, Merkle T, et al. The ABCD rule of dermatoscopy. High prospective value in the diagnosis of doubtful melanocytic skin lesions. J Am Acad Dermatol. 1994;30(4):551–9.PubMed
28.
Pagnanelli G, Soyer HP, Argenziano G, et al. Diagnosis of pigmented skin lesions by dermoscopy: web-based training improves diagnostic performance of non-experts. Br J Dermatol. 2003;148(4):698–702.PubMed
29.
Argenziano G, Soyer HP, Chimenti S, et al. Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet. J Am Acad Dermatol. 2003;48(5):679–93.PubMed
30.
Blum A, Rassner G, Garbe C. Modified ABC-point list of dermoscopy: a simplified and highly accurate dermoscopic algorithm for the diagnosis of cutaneous melanocytic lesions. J Am Acad Dermatol. 2003;48(5):672–8.PubMed
31.
Annessi G, Bono R, Sampogna F, et al. Sensitivity, specificity, and diagnostic accuracy of three dermoscopic algorithmic methods in the diagnosis of doubtful melanocytic lesions: the importance of light brown structureless areas in differentiating atypical melanocytic nevi from thin melanomas. J Am Acad Dermatol. 2007;56(5):759–67.PubMed
32.
Abbasi NR, Shaw HM, Rigel DS, et al. Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria. JAMA. 2004;292(22):2771–6.PubMed
33.
Liu W, Dowling JP, Murray WK, et al. Rate of growth in melanomas: characteristics and associations of rapidly growing melanomas. Arch Dermatol. 2006;142(12):1551–8.PubMed
34.
Pehamberger H, Steiner A, Wolff K. In vivo epiluminescence microscopy of pigmented skin lesions. I. Pattern analysis of pigmented skin lesions. J Am Acad Dermatol. 1987;17(4):571–83.PubMed
35.
Kittler H, Pehamberger H, Wolff K, et al. Diagnostic accuracy of dermoscopy. Lancet Oncol. 2002;3(3):159–65.PubMed
36.
Sober AJ, Chuang TY, Duvic M, et al. Guidelines of care for primary cutaneous melanoma. J Am Acad Dermatol. 2001;45(4):579–86.PubMed
37.
Koller J, Rettenbacher L. The influence of diagnostic biopsies on the sentinel lymph node detection in cutaneous melanoma. Arch Dermatol. 2000;136(9):1176.PubMed
38.
Coit DG, Andtbacka R, Bichakjian CK, et al. Melanoma. J Natl Compr Canc Netw. 2009;7(3):250–75.PubMed
39.
Cockerell CJ. Biopsy technique for pigmented lesions. Semin Cutan Med Surg. 1997;16(2):108–12.PubMed
40.
Smoller BR. Squamous cell carcinoma: from precursor lesions to high-risk variants. Modern Pathol. 2006;19(Suppl):S34–40.
41.
Hantschke M, Bastian BC, LeBoit PE. Consumption of the epidermis: a diagnostic criterion for the differential diagnosis of melanoma and Spitz nevus. Am J Surg Pathol. 2004;28(12):1621–5.PubMed
42.
Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg. 1970;172(5):902–8.PubMedPubMedCentral
43.
Balch CM, Buzaid AC, Soong SJ, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol. 2001;19(16):3635–48.PubMed
44.
Weedon D. Skin pathology. 2nd ed. Edinburgh: Churchill Livingstone; 2002.
45.
Clark JW. A classification of malignant melanoma in man correlated with histogenesis and biologic behaviour. In: Montagna W, Hu F (eds) Advances in the biology of the skin, vol 8. New York: Pergamon; 1967.
46.
Clark WH Jr, From L, Bernardino EA, et al. The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res. 1969;29(3):705–27.PubMed
47.
Schmid-Wendtner MH, Baumert J, Schmidt M, et al. Prognostic index for cutaneous melanoma: an analysis after follow-up of 2715 patients. Melanoma Res. 2001;11(6):619–26.PubMed
48.
Balch CM, Gershenwald JE, Soong SJ, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol. 2009;27(36):6199–206.PubMedPubMedCentral
49.
Arrington JH 3rd, Reed RJ, Ichinose H, et al. Plantar lentiginous melanoma: a distinctive variant of human cutaneous malignant melanoma. Am J Surg Pathol. 1977;1(2):131–43.PubMed
50.
Ferringer T. Update on immunohistochemistry in melanocytic lesions. Dermatol Clin. 2012;30(4):567–79.PubMed
51.
Alonso SR, Ortiz P, Pollan M, et al. Progression in cutaneous malignant melanoma is associated with distinct expression profiles: a tissue microarray-based study. Am J Pathol. 2004;164(1):193–203.PubMedPubMedCentral
52.
Schramm SJ, Mann GJ. Melanoma prognosis: a REMARK-based systematic review and bioinformatic analysis of immunohistochemical and gene microarray studies. Mol Cancer Ther. 2011;10(8):1520–8.PubMed
53.
Garbe C, Hauschild A, Volkenandt M, et al. Evidence and interdisciplinary consense-based German guidelines: diagnosis and surveillance of melanoma. Melanoma Res. 2007;17(6):393–9.PubMed
54.
Houghton AN, Coit DG, Daud A, et al. Melanoma. J Natl Compr Canc Netw. 2006;4(7):666–84.PubMed
55.
Saiag P, Bosquet L, Guillot B, et al. Management of adult patients with cutaneous melanoma without distant metastasis. 2005 update of the French Standards, options and recommendations guidelines. Summary report. Eur J Dermatol. 2007;17(4):325–31.PubMed
56.
Stoffels I, Dissemond J, Poeppel T, et al. Advantages of preoperative ultrasound in conjunction with lymphoscintigraphy in detecting malignant melanoma metastases in sentinel lymph nodes: a retrospective analysis in 221 patients with malignant melanoma AJCC Stages I and II. J Eur Acad Dermatol Venereol. 2012;26(1):79–85.PubMed
57.
Patnana M, Bronstein Y, Szklaruk J, et al. Multimethod imaging, staging, and spectrum of manifestations of metastatic melanoma. Clin Radiol. 2011;66(3):224–36.PubMed
58.
Hausmann D, Jochum S, Utikal J, et al. Comparison of the diagnostic accuracy of whole-body MRI and whole-body CT in stage III/IV malignant melanoma. J Dtsch Dermatol Ges. 2011;9(3):212–22.PubMed
59.
Bastiaannet E, Wobbes T, Hoekstra OS, et al. Prospective comparison of [18F]fluorodeoxyglucose positron emission tomography and computed tomography in patients with melanoma with palpable lymph node metastases: diagnostic accuracy and impact on treatment. J Clin Oncol. 2009;27(28):4774–80.PubMed
60.
Balch CM, Soong SJ, Smith T, et al. Long-term results of a prospective surgical trial comparing 2 cm vs. 4 cm excision margins for 740 patients with 1–4 mm melanomas. Ann Surg Oncol. 2001;8(2):101–8.PubMed
61.
Agarwala S, Lee S, Flaherty L, et al. Randomized phase III trial of high-dose interferon alfa-2b for 4 weeks induction only in patients with intermediate- and high-risk melanoma. J Clin Oncol. 2011;29: abstr 8505.
62.
Cascinelli N, Belli F, MacKie RM, et al. Effect of long-term adjuvant therapy with interferon alpha-2a in patients with regional node metastases from cutaneous melanoma: a randomised trial. Lancet. 2001;358(9285):866–9.PubMed
63.
Creagan ET, Dalton RJ, Ahmann DL, et al. Randomized, surgical adjuvant clinical trial of recombinant interferon alfa-2a in selected patients with malignant melanoma. J Clin Oncol. 1995;13(11):2776–83.PubMed
64.
Eggermont AM, Suciu S, MacKie R, et al. Post-surgery adjuvant therapy with intermediate doses of interferon alfa 2b versus observation in patients with stage IIb/III melanoma (EORTC 18952): randomised controlled trial. Lancet. 2005;366(9492):1189–96.PubMed
65.
Eggermont AM, Suciu S, Santinami M, et al. Adjuvant therapy with pegylated interferon alfa-2b versus observation alone in resected stage III melanoma: final results of EORTC 18991, a randomised phase III trial. Lancet. 2008;372(9633):117–26.PubMed
66.
Grob JJ, Dreno B, de la Salmoniere P, et al. Randomised trial of interferon alpha-2a as adjuvant therapy in resected primary melanoma thicker than 1.5 mm without clinically detectable node metastases. French Cooperative Group on Melanoma. Lancet. 1998;351(9120):1905–10.PubMed
67.
Hancock BW, Wheatley K, Harris S, et al. Adjuvant interferon in high-risk melanoma: the AIM HIGH Study-United Kingdom Coordinating Committee on Cancer Research randomized study of adjuvant low-dose extended-duration interferon Alfa-2a in high-risk resected malignant melanoma. J Clin Oncol. 2004;22(1):53–61.PubMed
68.
Hansson J, Aamdal S, Bastholt L, et al. Two different durations of adjuvant therapy with intermediate-dose interferon alfa-2b in patients with high-risk melanoma (Nordic IFN trial): a randomised phase 3 trial. Lancet Oncol. 2011;12(2):144–52.PubMed
69.
Hauschild A, Weichenthal M, Rass K, et al. Prospective randomized multicenter adjuvant dermatologic cooperative oncology group trial of low-dose interferon alfa-2b with or without a modified high-dose interferon alfa-2b induction phase in patients with lymph node-negative melanoma. J Clin Oncol. 2009;27(21):3496–502.PubMed
70.
Kirkwood JM, Ibrahim JG, Sondak VK, et al. High- and low-dose interferon alfa-2b in high-risk melanoma: first analysis of intergroup trial E1690/S9111/C9190. J Clin Oncol. 2000;18(12):2444–58.PubMed
71.
Kirkwood JM, Ibrahim JG, Sosman JA, et al. High-dose interferon alfa-2b significantly prolongs relapse-free and overall survival compared with the GM2-KLH/QS-21 vaccine in patients with resected stage IIB–III melanoma: results of intergroup trial E1694/S9512/C509801. J Clin Oncol. 2001;19(9):2370–80.PubMed
72.
Kirkwood JM, Strawderman MH, Ernstoff MS, et al. Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684. J Clin Oncol. 1996;14(1):7–17.PubMed
73.
Pehamberger H, Soyer HP, Steiner A, et al. Adjuvant interferon alfa-2a treatment in resected primary stage II cutaneous melanoma. Austrian Malignant Melanoma Cooperative Group. J Clin Oncol. 1998;16(4):1425–9.PubMed
74.
Garbe C, Radny P, Linse R, et al. Adjuvant low-dose interferon alpha-2a with or without dacarbazine compared with surgery alone: a prospective-randomized phase III DeCOG trial in melanoma with regional lymph node metastasis. Ann Oncol. 2008;19(6):1195–201.PubMed
75.
Mocellin S, Pasquali S, Rossi CR, et al. Interferon alpha adjuvant therapy in patients with high-risk melanoma: a systematic review and meta-analysis. J Natl Cancer Inst. 2010;102(7):493–501.PubMed
76.
Pirard D, Heenen M, Melot C, et al. Interferon alpha as adjuvant postsurgical treatment of melanoma: a meta-analysis. Dermatology. 2004;208(1):43–8.PubMed
77.
Wheatley K, Ives N, Hancock B, et al. Does adjuvant interferon-alpha for high-risk melanoma provide a worthwhile benefit? A meta-analysis of the randomised trials. Cancer Treat Rev. 2003;29(4):241–52.PubMed
78.
Stevens G, Thompson JF, Firth I, et al. Locally advanced melanoma: results of postoperative hypofractionated radiation therapy. Cancer. 2000;88(1):88–94.PubMed
79.
Balch CM, Soong SJ. Predicting outcomes in metastatic melanoma. J Clin Oncol. 2008;26(2):168–9.PubMed
80.
Francken AB, Accortt NA, Shaw HM, et al. Prognosis and determinants of outcome following locoregional or distant recurrence in patients with cutaneous melanoma. Ann Surg Oncol. 2008;15(5):1476–84.PubMed
81.
Komorowski AL, Wysocki WM, White RL Jr. Surgical management of solitary metastatic melanoma. Acta Chir Belg. 2009;109(2):155–8.PubMed
82.
Ollila DW. Complete metastasectomy in patients with stage IV metastatic melanoma. Lancet Oncol. 2006;7(11):919–24.PubMed
83.
Petersen RP, Hanish SI, Haney JC, et al. Improved survival with pulmonary metastasectomy: an analysis of 1720 patients with pulmonary metastatic melanoma. J Thorac Cardiovasc Surg. 2007;133(1):104–10.PubMed
84.
Wasif N, Bagaria SP, Ray P, et al. Does metastasectomy improve survival in patients with Stage IV melanoma? A cancer registry analysis of outcomes. J Surg Oncol. 2011;104(2):111–5.PubMedPubMedCentral
85.
Marchal F, Brunaud L, Bazin C, et al. Radiofrequency ablation in palliative supportive care: early clinical experience. Oncol Rep. 2006;15(2):495–9.PubMed
86.
Marnitz S, Hoecht S, Hinkelbein W. The role of radiotherapy in the management of malignant melanoma. Front Radiat Ther Oncol. 2006;39:140–8.PubMed
87.
Stevens G, McKay MJ. Dispelling the myths surrounding radiotherapy for treatment of cutaneous melanoma. Lancet Oncol. 2006;7(7):575–83.PubMed
88.
Testori A, Rutkowski P, Marsden J, et al. Surgery and radiotherapy in the treatment of cutaneous melanoma. Ann Oncol. 2009;20 Suppl 6:vi22–9.
89.
Geara FB, Ang KK. Radiation therapy for malignant melanoma. Surg Clin North Am. 1996;76(6):1383–98.PubMed
90.
Bhatnagar AK, Flickinger JC, Kondziolka D, et al. Stereotactic radiosurgery for four or more intracranial metastases. Int J Radiat Oncol Biol Phys. 2006;64(3):898–903.PubMed
91.
Scorsetti M, Facoetti A, Navarria P, et al. Hypofractionated stereotactic radiotherapy and radiosurgery for the treatment of patients with radioresistant brain metastases. Anticancer Res. 2009;29(10):4259–63.PubMed
92.
Dehesa LA, Vilar-Alejo J, Valeron-Almazan P, et al. Experience in the treatment of cutaneous in-transit melanoma metastases and satellitosis with intralesional interleukin-2. Actas Dermosifiliogr. 2009;100(7):571–85.PubMed
93.
von Nida J, Quirk C. Successful treatment of in-transit melanoma metastases using topical 2-4 dinitrochlorobenzene. Australas J Dermatol. 2003;44(4):277–80.
94.
Kandamany N, Mahaffey P. Carbon dioxide laser ablation as first-line management of in-transit cutaneous malignant melanoma metastases. Lasers Med Sci. 2009;24(3):411–4.PubMed
95.
Moreno-Ramirez D, de la Cruz L, Ferrandiz L, et al. Study and treatment of locally advanced melanoma. Actas Dermosifiliogr. 2009;100(9):767–79.PubMed
96.
Moller MG, Salwa S, Soden DM, et al. Electrochemotherapy as an adjunct or alternative to other treatments for unresectable or in-transit melanoma. Expert Rev Anticancer Ther. 2009;9(11):1611–30.PubMed
97.
Snoj M, Cemazar M, Srnovrsnik T, et al. Limb sparing treatment of bleeding melanoma recurrence by electrochemotherapy. Tumori. 2009;95(3):398–402.PubMed
98.
Deroose JP, Eggermont AM, van Geel AN, et al. Isolated limb perfusion for melanoma in-transit metastases: developments in recent years and the role of tumor necrosis factor alpha. Curr Opin Oncol. 2011;23(2):183–8.PubMed
99.
Alexander HR Jr, Fraker DL, Bartlett DL, et al. Analysis of factors influencing outcome in patients with in-transit malignant melanoma undergoing isolated limb perfusion using modern treatment parameters. J Clin Oncol. 2010;28(1):114–8.PubMedPubMedCentral
100.
Cornett WR, McCall LM, Petersen RP, et al. Randomized multicenter trial of hyperthermic isolated limb perfusion with melphalan alone compared with melphalan plus tumor necrosis factor: American College of Surgeons Oncology Group Trial Z0020. J Clin Oncol. 2006;24(25):4196–201.PubMed
101.
Robert C, Thomas L, Bondarenko I, et al. Ipilimumab plus dacarbazine for previously untreated metastatic melanoma. N Engl J Med. 2011;364(26):2517–26.PubMed
102.
Hodi FS, O’Day SJ, McDermott DF, et al. Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med. 2010;363(8):711–23.PubMedPubMedCentral
103.
Sznol M, Kluger H, Hodi F, et al. Survival and long-term follow-up of safety and response in patients with advanced melanoma in a phase I trial of nivolumab. J Clin Oncol. 2013;31 Suppl:abstr CRA9006.
104.
Hamid O, Robert C, Daud A, et al. Safety and tumor responses with lambrolizumab (Anti-PD-1) in melanoma. N Engl J Med. 2013;369(2):134–44.PubMedPubMedCentral
105.
Wolchok JD, Kluger H, Callahan MK, et al. Nivolumab plus ipilimumab in advanced melanoma. N Engl J Med. 2013;369(2):122–33.PubMed
106.
Chapman PB, Hauschild A, Robert C, et al. Improved survival with vemurafenib in melanoma with BRAF V600E mutation. N Engl J Med. 2011;364(26):2507–16.PubMedPubMedCentral
107.
Sosman JA, Kim KB, Schuchter L, et al. Survival in BRAF V600-mutant advanced melanoma treated with vemurafenib. N Engl J Med. 2012;366(8):707–14.PubMedPubMedCentral
108.
Hauschild A, Grob JJ, Demidov LV, et al. Dabrafenib in BRAF-mutated metastatic melanoma: a multicentre, open-label, phase 3 randomised controlled trial. Lancet. 2012;380(9839):358–65.PubMed
109.
Flaherty KT, Robert C, Hersey P, et al. Improved survival with MEK inhibition in BRAF-mutated melanoma. N Engl J Med. 2012;367(2):107–14.PubMed
110.
Flaherty KT, Infante JR, Daud A, et al. Combined BRAF and MEK inhibition in melanoma with BRAF V600 mutations. N Engl J Med. 2012;367(18):1694–703.PubMedPubMedCentral
111.
Ascierto P, Berking C, Agarwala S, et al. Efficacy and safety of oral MEK162 in patients with locally advanced and unresectable or metastatic cutaneous melanoma harboring BRAFV600 or NRAS mutations. J Clin Oncol. 2012;30 Suppl:abstr 8511.
112.
Huncharek M, Caubet JF, McGarry R. Single-agent DTIC versus combination chemotherapy with or without immunotherapy in metastatic melanoma: a meta-analysis of 3273 patients from 20 randomized trials. Melanoma Res. 2001;11(1):75–81.PubMed
113.
Avril MF, Aamdal S, Grob JJ, et al. Fotemustine compared with dacarbazine in patients with disseminated malignant melanoma: a phase III study. J Clin Oncol. 2004;22(6):1118–25.PubMed
114.
Middleton MR, Grob JJ, Aaronson N, et al. Randomized phase III study of temozolomide versus dacarbazine in the treatment of patients with advanced metastatic malignant melanoma. J Clin Oncol. 2000;18(1):158–66.PubMed
Metadata
Title
Melanoma: Diagnosis, Staging, and Treatment. Consensus group recommendations
Authors
Alfonso Berrocal
Luis Cabañas
Enrique Espinosa
Ricardo Fernández-de-Misa
Salvador Martín-Algarra
José Carlos Martínez-Cedres
Luis Ríos-Buceta
José Luis Rodríguez-Peralto
Publication date
01-09-2014
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 9/2014
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-014-0148-2

Other articles of this Issue 9/2014

Advances in Therapy 9/2014 Go to the issue

Review

Current Perspectives on Interferon Beta-1b for the Treatment of Multiple Sclerosis

Original Research

Efficacy and Tolerability of Fixed-Combination Brinzolamide/Timolol in Latin American Patients with Open-Angle Glaucoma or Ocular Hypertension Previously on Brimonidine/Timolol Fixed Combination

Original Research

A Cohort Study of the Relationship Between Anger and Chronic Spontaneous Urticaria

Erratum

Erratum to: Everolimus Plus Exemestane in Postmenopausal Patients with HR+ Breast Cancer: BOLERO-2 Final Progression-Free Survival Analysis

Original Research

Clinical Effectiveness of Liraglutide Across Body Mass Index in Patients with Type 2 Diabetes in the United States: A Retrospective Cohort Study

Review

Fixed-Dose Combination of Tafluprost and Timolol in the Treatment of Open-Angle Glaucoma and Ocular Hypertension: Comparison with Other Fixed-Combination Products
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits