National Cancer Institute®
Last Modified: August 1, 2002
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
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.
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
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. email@example.com
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.
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
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. firstname.lastname@example.org
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.
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. email@example.com
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. firstname.lastname@example.org
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. email@example.com
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.
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.
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. firstname.lastname@example.org
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.
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.
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.
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.
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.
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. email@example.com
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.
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