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NCI CANCERLIT® Search: Therapy of Melanoma - August 2002
National Cancer Institute®
Last Modified: August 1, 2002
- Delcath Systems' phase III trial for inoperable cancer is planned at Sydney Melanoma Unit.
- Malignant melanoma: treatments emerging, but early detection is still key.
- Phase I trial of adoptive immunotherapy with cytolytic T lymphocytes immunized against a tyrosinase epitope.
- Adjuvant interferon-alpha for melanoma revisited: news from old and new studies.
- Use of sunscreens in families living in Switzerland.
- Isolated limb perfusion: a literature review.
- Early detection of melanoma: the best strategy for a favorable prognosis.
- Dermoscopy and preoperative evaluation of melanoma thickness.
- Lymph node dissection for clinically evident lymph node metastases of malignant melanoma.
- Effect of temozolomide on central nervous system relapse in patients with advanced melanoma.
- Combination of surgery and gamma knife radiosurgery--a therapeutic option for patients with tumors of nasal cavity or paranasal sinuses
- Adjuvant high-dose interferon revisited.
- Adjuvant high-dose interferon alfa-2b in patients with high-risk melanoma.
- Predictors of extensive subclinical spread in nonmelanoma skin cancer treated with Mohs micrographic surgery.
- The tumour suppressor p33ING1 does not enhance camptothecin-induced cell death in melanoma cells.
- Effect of the dose and composition of an autologous hapten-modified melanoma vaccine on the development of delayed-type hypersensitivity
Table of Contents
1
UI - 12113232
AU - Anonymous
TI -
Delcath Systems' phase III trial for inoperable cancer is planned at
Sydney Melanoma Unit.
SO - Expert Rev Anticancer Ther 2002 Apr;2(2):138-9
2
UI - 12109636
AU - Masci P; Borden EC
TI -
Malignant melanoma: treatments emerging, but early detection is still
key.
SO - Cleve Clin J Med 2002 Jul;69(7):529, 533-4, 536-8 passim
AD - Department of Hematology/Oncology and Center for Cancer Drug Discovery
and Development, The Cleveland Clinic Foundation, OH 44195, USA.
Although we are beginning to develop treatment options for malignant
melanoma, earlier recognition of potential primary melanomas remains the
most effective way to increase survival in this highly malignant
disease. This article reviews prominent risk factors for melanoma, key
physical findings in at-risk patients, new melanoma staging guidelines,
and recent and emerging therapy options.
3
UI - 12118032
AU - Wolchok JD; Chapman PB
TI -
Phase I trial of adoptive immunotherapy with cytolytic T lymphocytes
immunized against a tyrosinase epitope.
SO - J Clin Oncol 2002 Jul 15;20(14):3176; discussion 3176-7
4
UI - 11843241
AU - Punt CJ; Eggermont AM
TI -
Adjuvant interferon-alpha for melanoma revisited: news from old and new
studies.
SO - Ann Oncol 2001 Dec;12(12):1663-6
AD - Department of Medical Oncology, University Medical Center St. Radboud
Nijmegen, The Netherlands. c.punt@onco.azn.nl
Currently the data from 12 randomised phase III trials investigating the
role of interferon-alpha (IFNalpha) in patients with stage II-III
high-risk melanoma are available. The most prominent differences between
these trials concern the dose of IFNalpha, the duration of IFNalpha
administration, and the stage of disease. Some of these trials have not
yet reached maturity, but despite this the positive results from some
immature trials have attracted considerable attention. When only data
from mature trials is considered, one may conclude that the use of
high-dose IFNalpha does prolong disease-free survival (DFS) but not
overall survival (OS). Combined data from low-dose IFNalpha trials does
not suggest a benefit in either DFS or OS. A trial with
intermediate-dose IFNalpha is still immature. Therefore currently the
routine use of IFNalpha cannot be recommended outside the scope of
clinical trials.
5
UI - 12037448
AU - Berret J; Liardet S; Scaletta C; Panizzon R; Hohlfeld P; Applegate LA
TI -
Use of sunscreens in families living in Switzerland.
SO - Dermatology 2002;204(3):202-8
AD - Laboratory of Oxidative Stress and Aging, University Hospital, CHUV,
Lausanne, Switzerland.
BACKGROUND: The hazards due to sun exposure are well known. Many recent
studies have emphasized the protection against the harmful effects of
the sun by the use of sunscreens and, moreover, by staying in the shade
and wearing long-sleeved shirts, hats and sunglasses. Switzerland has
one of the highest rates of skin cancer induction in Europe and the
incidence of melanoma in Switzerland is constantly increasing with an
incidence of 10-12/100,000 inhabitants/year. Interestingly, some studies
have evoked the possibility that sunscreen use can increase the risk of
melanoma by increasing overall sun exposure. OBJECTIVE AND METHODS: In
this context, the aim of our study was to estimate the amount of sun
exposure of children, and their parents, living in Switzerland and to
give a description of how they protect themselves against sun
irradiation. Questionnaires were provided to pediatricians in every
state (canton) in Switzerland and were given to families coming for
consultation. RESULTS: A total of 328 forms including 1,285 individuals
were returned from most of the cantons in Switzerland. The majority of
the Swiss families had 2 children under 16 years of age with middle-aged
parents (30-45 years) and a central European skin type (light skin of
type II-III, brown or blue eyes, and brown to blond hair). An important
sun exposure was noted even though the population seems to be conscious
of the associated dangers. Sunscreens were the first-line defense
against sun exposure with clothing and shielding oneself from the sun
not being highly used. Moreover, sunscreens tended to be misused with
most people applying them at the beach or swimming pool (instead of 15
min before exposure) and few applications throughout the day.
CONCLUSIONS: Prevention should imperatively be emphasized for lower
overall sun exposure as sunscreens are primarily used at the beach and
not in routine daily exposure. In addition, it is agreed that prevention
campaigns would be better directed towards children because up to 80% of
detrimental sun exposure occurs during childhood. Copyright 2002 S.
Karger AG, Basel
6
UI - 12139123
AU - Schaadt J; Crowley R; Miller D; Kavanah M
TI -
Isolated limb perfusion: a literature review.
SO - J Extra Corpor Technol 2002 Jun;34(2):130-43
AD - VA Hospital West Roxbury, Massachusetts, USA. jschaadt@stm.com
Through patient education, biological research, and technological
advances, the rate of many cancers in the United States of America is
declining. However, the incidence of melanoma is rising steadily, as are
the efforts and resources allocated to its treatment. Isolated limb
perfusion, ILP, is a standard of care for treating recurrent malignant
melanoma confined to a limb. Although an extracorporeal procedure, only
a small percentage of perfusionists are experienced regarding ILP's
indications and performance techniques. Use of ILP may increase as the
incidence of melanoma increases. This two-part review is designed to
familiarize the perfusionist with the procedure and the disease it
treats. Part I reviews the history of isolated limb perfusion, the
diagnosis and classification of malignant melanoma, and the
applicability of ILP in its treatment. Part II details a procedural
overview and technical considerations of the therapy from the
perfusionist perspective. The review concludes with patient selection,
outcomes, and the future of ILP as well as other applications for the
hyperthermic regional delivery of chemotherapy using extracorporeal
technology.
7
UI - 12074854
AU - Brenner S; Tamir E
TI -
Early detection of melanoma: the best strategy for a favorable
prognosis.
SO - Clin Dermatol 2002 May-Jun;20(3):203-11
AD - Department of Dermatology, Tel Aviv Sourasky Medical Center and Sackler
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
derma@tasmc.health.gov.il
8
UI - 12074872
AU - De Giorgi V; Carli P
TI -
Dermoscopy and preoperative evaluation of melanoma thickness.
SO - Clin Dermatol 2002 May-Jun;20(3):305-8
AD - Department of Dermatology, University of Florence, Florence, Italy.
vdegi@tin.it
9
UI - 12099654
AU - Meyer T; Merkel S; Gohl J; Hohenberger W
TI -
Lymph node dissection for clinically evident lymph node metastases of
malignant melanoma.
SO - Eur J Surg Oncol 2002 Jun;28(4):424-30
AD - Department of Surgery, University of Erlangen, Erlangen, Germany.
thomas.meyer@chir.imed.uni-erlangen.de
AIMS: A considerable number of melanoma patients present with clinically
evident regional lymph node metastases. Factors influencing prognosis
following therapeutic lymph node dissection (TLND) were evaluated.
METHODS: In total 140 patients (68 women, 72 men, median age 53 years)
with established regional lymph node metastases, but without clinically
detectable distant metastases, received cervical, axillary or
ilioinguinal TLND between 1978 and 1997 and were retrospectively
reviewed. Uni- and multivariate survival analysis was performed.
RESULTS: Median survival for all 140 patients was 25 months; the
observed overall 5 year survival rate was 30%. Age greater than 50
years, primary tumour site on the trunk, more than three lymph node
metastases and extracapsular spread were associated with a poor
prognosis. In multivariate analysis age (< or =50 years vs >50 years,
P=0.02), location of the primary tumour (non-truncal vs truncal,
P=0.005), number of lymph nodes involved ( n< or =3 vsn >3, P=0.01) and
extracapsular spread (none vs present, P=0.04) proved to be independent
prognostic factors. CONCLUSIONS: TLND is worthwhile and offers a
potential chance of cure in about one-third of melanoma patients with
established regional lymph node metastases. There are subgroups with a
particularly poor prognosis in whom the benefit of radical surgery alone
is limited.
10
UI - 11930115
AU - Paul MJ; Summers Y; Calvert AH; Rustin G; Brampton MH; Thatcher N;
TI -
Middleton MR
Effect of temozolomide on central nervous system relapse in patients
with advanced melanoma.
SO - Melanoma Res 2002 Apr;12(2):175-8
AD - Cancer Research UK Department of Medical Oncology, Christie Hospital NHS
Trust, Manchester, UK.
Temozolomide has shown efficacy in the treatment of metastatic melanoma
similar to that of dacarbazine (DTIC), the standard chemotherapy, but
with the added benefit of penetration into the central nervous system
(CNS). Isolated CNS relapse is increasingly a problem for patients who
respond to biochemotherapy. By replacing DTIC with temozolomide in
treatment regimens, the incidence of CNS relapse might be reduced. This
hypothesis is difficult to test in a prospective randomized controlled
trial because of the large number of patients that would be required. We
have examined this question in a retrospective case control study,
observing the rates of CNS relapse in advanced metastatic melanoma
patients responding to DTIC- or temozolomide-based chemotherapy in three
institutions. Twenty-one DTIC and 20 temozolomide responders were
identified, and have been followed up for a median of 19.0 months (range
6.0-74.3 months). CNS relapse occurred in nine DTIC- and two
temozolomide-treated patients, a statistically significant difference in
favour of the new agent (P = 0.03). These results support the
investigation of temozolomide as a replacement for DTIC in systemic
treatment regimens for melanoma.
11
UI - 12068475
AU - Habermann W; Zanarotti U; Groell R; Wolf G; Stammberger H; Sutter B;
TI -
Pendl G
Combination of surgery and gamma knife radiosurgery--a therapeutic
option for patients with tumors of nasal cavity or paranasal sinuses
infiltrating the skull base.
SO - Acta Otorhinolaryngol Ital 2002 Apr;22(2):74-9
AD - Department of Otolaryngology-Head and Neck Surgery, University of Graz,
Medical School, Austria. w_habermann@yahoo.com
The purpose of this study was to investigate whether patients operated
for skull base-infiltrating malignant tumors of the nasal cavity and/or
the paranasal sinuses benefit from an additional Gamma knife
radiosurgery. Case series: eight consecutive patients, (male: female
ratio = 1:1, mean age = 52 years, range 34 to 79 years) presented with 2
cyclindric cell carcinomas, 2 adenocarcinomas, 2 malignant
neuroblastomas, 1 squamous cell carcinoma, 1 amelanotic melanoma. Tumor
stages (UICC) were: 1 T1, 3 T2, 3 T3, 1 T4, all N0, all M0. All patients
were primarily treated surgically and 4 weeks later received additional
stereotactic radiosurgery. Follow-up was based on computerized
tomography (CT), magnetic resonance imaging (MRI), endoscopy, and
biopsy. The course of disease was compared to tumor courses with surgery
but without radiosurgery reported in literature. Four times endoscopic
endonasal surgery (EES), once EES in combination with fluorescein
technique, once EES plus external approach of frontal sinus, once
lateral rhinotomy was performed. All 8 cases underwent radiosurgery
(Leksell gamma knife) 4 weeks after surgery. Thirty six months after
radiosurgery 6 patients were alive (4 patients without evidence of
disease, 1 patient with pulmonary metastasis but without local
recurrence, 1 patient with regional metastasis but no local recurrence),
1 patient died 11 months after treatment due to disease, 1 patient died
due to a second malignancy. No negative or adverse effects due to
radiosurgery were observed. The combination of microsurgery with Leksell
Gamma knife radiosurgery appears to be an encouraging therapeutic
option. To date no adverse effects have been observed in the presented
cases.
12
UI - 10882326
AU - Sondak VK; Flaherty LE
TI -
Adjuvant high-dose interferon revisited.
SO - Cancer J 2000 May-Jun;6(3):132-4
AD - University of Michigan Comprehensive Cancer Center, Ann Arbor
48109-0932, USA.
13
UI - 10882328
AU - Jonasch E; Kumar UN; Linette GP; Hodi FS; Soiffer RJ; Ryan BF; Sober AJ;
TI -
Mihm MC; Tsao H; Langley RG; Cosimi BA; Gadd MA; Tanabe KK; Souba W;
Haynes HA; Barnhill R; Osteen R; Haluska FG
Adjuvant high-dose interferon alfa-2b in patients with high-risk
melanoma.
SO - Cancer J 2000 May-Jun;6(3):139-45
AD - Melanoma Program at Massachusetts General Hospital, and Dana Farber
Cancer Institute, Boston 02114, USA.
We performed an analysis of toxicity and survival in stage III melanoma
patients receiving adjuvant interferon alfa-2b (IFN). This was a
retrospective single-arm analysis of 40 patients with stage III melanoma
who received (IFN) administered at maximum tolerated doses of 20
mU/m2/day intravenously (i.v.) for 1 month and 10 mU/m2 three times per
week subcutaneously (s.c.) for 48 weeks. Toxicity in our series is
comparable to that experienced in the Eastern Cooperative Oncology Group
(ECOG) 1684 trial, except for higher rates of dose-limiting
myelosuppression and hepatotoxicity. All 40 patients experienced
constitutional symptoms, but only 14/40 (35%) experienced grade 3 to 4
symptoms. Of the 40 patients, 36 (90%) experienced neurologic symptoms,
but only seven (17.5%) experienced grade 3 to 4 neurotoxicity. Two
patients stopped treatment because of severe psychiatric symptoms; one
patient attempted suicide, and a psychosis developed in another.
Thirty-nine (97.5%) patients experienced myelosuppression; 31 (77.5%)
developing grade 3 to 4 myelosuppression. Hepatotoxicity was evident in
39 (97.5%) patients, and 26 (65%) experienced grade 3 to 4
hepatotoxicity. Three patients (7.5%) experienced mild renal toxicity.
At a median follow-up of 27 months from initiation of therapy, there
have been 19 relapses (47.5% disease-free survival [DFS]) and 10 deaths
(75% OS) resulting from progression of disease. The DFS compares with
the treatment arm in ECOG 1684 at 27 months, but overall survival is
higher in our series of patients at the same time point. In a single
program setting, IFN can be administered with similar side effects and
outcome profiles seen in multi-institutional studies. Modifications in
the induction regimen resulted in notably higher hematologic and hepatic
toxicities but did not preclude administering further therapy and did
not result in increased attrition rate among patients: only nine
patients (22.5%) had their treatment stopped as a result of IFN-related
toxicity. In comparison, 26% of patients had to have their treatment
discontinued because of toxicity in ECOG 1684.
14
UI - 12164742
AU - Batra RS; Kelley LC
TI -
Predictors of extensive subclinical spread in nonmelanoma skin cancer
treated with Mohs micrographic surgery.
SO - Arch Dermatol 2002 Aug;138(8):1043-51
AD - Department of Dermatology, Stanford University School of Medicine, CA,
USA.
BACKGROUND: In nonmelanoma skin cancer, the clinically visible portion
may represent a small fraction of microscopic tumor spread. Previous
studies have examined individual risk factors for subclinical spread
based on patient and tumor characteristics. However, these risk factors
have not been prioritized or studied in combination. OBJECTIVE: To
identify the most predictive risk factors for extensive subclinical
tumor spread. DESIGN: Retrospective analysis of 1131 Mohs micrographic
surgical cases. Variables analyzed included patient age, sex, and immune
status and lesion size, location, histologic subtype, and recurrence.
Logistic regression was applied to identify important combinations of
tumor characteristics and to quantify relative odds of spread. SETTING:
Academic referral center. PATIENTS: Consecutive sample of all referred
patients treated by a single Mohs micrographic surgeon in a 3-year
period. MAIN OUTCOME MEASURE: Number of Mohs micrographic surgical
layers required to clear a tumor, with 3 or more layers defined as
extensive subclinical spread. RESULTS: The highest-risk tumors, with
odds ratios greater than 6.0, were basosquamous and morpheaform basal
cell carcinoma (BCC) on the nose, morpheaform BCC on the cheek, and
those with a preoperative size greater than 25 mm. Other important risk
factors were recurrent and nodular BCC on the nose; location on the
eyelid, temple, or ear helix; neck tumors and recurrent BCC in men; and
tumor size greater than 10 mm. Patients younger than 35 years were at
lower risk. Increasing age and immunocompromise were not significant
predictors. CONCLUSION: Identification of lesions likely to exhibit
extensive subclinical spread can help guide management to ensure
complete tumor eradication and thereby reduce the risk of recurrence and
its associated morbidity and cost.
15
UI - 12012016
AU - Cheung KJ Jr; Li G
TI -
The tumour suppressor p33ING1 does not enhance camptothecin-induced cell
death in melanoma cells.
SO - Int J Oncol 2002 Jun;20(6):1319-22
AD - Division of Dermatology, Department of Medicine, University of British
Columbia, and Vancouver Hospital and Health Sciences Centre, V6H 3Z6,
Canada.
The tumour suppressor ING1 shares many biological functions with p53,
such as cell cycle arrest, DNA repair, apoptosis, and chemosensitivity.
Previous findings indicate that the isoform p24ING1 is capable of
enhancing chemosensitivity in human fibroblasts. To investigate if the
p33ING1 isoform is also involved in chemosensitivity, we overexpressed
p33ING1 in melanoma cells and assessed for cell death after treatment
with camptothecin. Results from the sulforhodamine B cell survival assay
and flow cytometry analysis show no significant difference among cells
transfected with vector, p33ING1, and antisense p33ING1. Furthermore,
co-transfection of the p33ING1 and p53 constructs had no effect on the
frequency of cell death, indicating that there is no synergistic effect
between the two tumour suppressors in camptothecin-induced cell death in
melanoma cells. This is in contrast to previously observed collaboration
between p33ING1 and p53 in DNA repair and apoptosis. Taken together, we
demonstrate that p33ING1 does not enhance camptothecin-induced cell
death in melanoma cells.
16
UI - 12111120
AU - Berd D; Sato T; Mastrangelo MJ
TI -
Effect of the dose and composition of an autologous hapten-modified
melanoma vaccine on the development of delayed-type hypersensitivity
responses.
SO - Cancer Immunol Immunother 2002 Aug;51(6):320-6
AD - Department of Medicine, Kimmel Cancer Center, Thomas Jefferson
University, 1015 Walnut St., Suite 1024 Philadelphia PA 19107, USA.
d_berd@mail.jci.tju.edu
We have reported that treatment of melanoma patients with a vaccine
consisting of autologous tumor cells modified with the hapten,
dinitrophenyl (DNP) and preceded by low-dose cyclophosphamide induces
delayed-type hypersensitivity (DTH) to autologous, unmodified tumor
cells and that this response is a significant predictor of survival. We
analyzed the vaccines prepared for 284 patients who were treated
following resection of regional or distant metastases to find out
whether the dose and composition determined the immunological response.
A positive DTH response (> or =5 mm induration) to unmodified autologous
tumor cells was induced in 57% of the patients (median: 5 mm; range:
0-22 mm). Regression analysis showed no significant association between
the magnitude of DTH and the number of live (trypan blue exclusion)
melanoma cells per dose over a dosage range of 0.5-25.0 x 10(6).
Surprisingly, there was a small but significant positive relationship
between the mean number of dead cells in the vaccines of a given patient
and that patient's maximum DTH to unmodified melanoma cells. Only 37% of
patients whose vaccines contained >50% live cells developed DTH, as
compared with 69% and 65% of patients whose vaccines contained 26% to
50% or < or =25% live cells, respectively. Thus, it appears that dead
tumor cells contribute to the immunogenicity of the DNP vaccine, but
other factors such as the administration schedule may be more important
determinants of immunological and clinical outcome.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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