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Management of metastatic cutaneous melanoma: updates in clinical practice

In recent years, several drugs have been approved for the treatment of patients with metastatic cutaneous melanoma, completely reshaping the landscape of this aggressive disease. Immune therapy with cytotoxic T-lymphocyte antigen 4 and programmed cell death-1 inhibitors yielded significant and durab...

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Autores principales: Schvartsman, Gustavo, Taranto, Patricia, Glitza, Isabella C., Agarwala, Sanjiv S., Atkins, Michael B., Buzaid, Antonio C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6535734/
https://www.ncbi.nlm.nih.gov/pubmed/31205512
http://dx.doi.org/10.1177/1758835919851663
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author Schvartsman, Gustavo
Taranto, Patricia
Glitza, Isabella C.
Agarwala, Sanjiv S.
Atkins, Michael B.
Buzaid, Antonio C.
author_facet Schvartsman, Gustavo
Taranto, Patricia
Glitza, Isabella C.
Agarwala, Sanjiv S.
Atkins, Michael B.
Buzaid, Antonio C.
author_sort Schvartsman, Gustavo
collection PubMed
description In recent years, several drugs have been approved for the treatment of patients with metastatic cutaneous melanoma, completely reshaping the landscape of this aggressive disease. Immune therapy with cytotoxic T-lymphocyte antigen 4 and programmed cell death-1 inhibitors yielded significant and durable responses, achieving long-term disease control in up to 40% of the patients. BRAF inhibitors (BRAFi), in combination with MEK inhibitors, also resulted in improved overall survival compared with single-agent BRAFi in patients with BRAFV600-mutated metastatic melanoma. The optimized sequencing and duration of treatment, however, is yet to be found. In this article, we thoroughly review current data and discuss how to best sequence the various treatment modalities available at present, based on four distinct clinical presentations commonly seen in clinic. In addition, we review treatment options beyond checkpoint inhibitors and targeted therapy, which may be required by patients failing such effective treatments.
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spelling pubmed-65357342019-06-14 Management of metastatic cutaneous melanoma: updates in clinical practice Schvartsman, Gustavo Taranto, Patricia Glitza, Isabella C. Agarwala, Sanjiv S. Atkins, Michael B. Buzaid, Antonio C. Ther Adv Med Oncol Review In recent years, several drugs have been approved for the treatment of patients with metastatic cutaneous melanoma, completely reshaping the landscape of this aggressive disease. Immune therapy with cytotoxic T-lymphocyte antigen 4 and programmed cell death-1 inhibitors yielded significant and durable responses, achieving long-term disease control in up to 40% of the patients. BRAF inhibitors (BRAFi), in combination with MEK inhibitors, also resulted in improved overall survival compared with single-agent BRAFi in patients with BRAFV600-mutated metastatic melanoma. The optimized sequencing and duration of treatment, however, is yet to be found. In this article, we thoroughly review current data and discuss how to best sequence the various treatment modalities available at present, based on four distinct clinical presentations commonly seen in clinic. In addition, we review treatment options beyond checkpoint inhibitors and targeted therapy, which may be required by patients failing such effective treatments. SAGE Publications 2019-05-22 /pmc/articles/PMC6535734/ /pubmed/31205512 http://dx.doi.org/10.1177/1758835919851663 Text en © The Author(s), 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Schvartsman, Gustavo
Taranto, Patricia
Glitza, Isabella C.
Agarwala, Sanjiv S.
Atkins, Michael B.
Buzaid, Antonio C.
Management of metastatic cutaneous melanoma: updates in clinical practice
title Management of metastatic cutaneous melanoma: updates in clinical practice
title_full Management of metastatic cutaneous melanoma: updates in clinical practice
title_fullStr Management of metastatic cutaneous melanoma: updates in clinical practice
title_full_unstemmed Management of metastatic cutaneous melanoma: updates in clinical practice
title_short Management of metastatic cutaneous melanoma: updates in clinical practice
title_sort management of metastatic cutaneous melanoma: updates in clinical practice
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6535734/
https://www.ncbi.nlm.nih.gov/pubmed/31205512
http://dx.doi.org/10.1177/1758835919851663
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