TY - JOUR
T1 - Management of metastatic cutaneous melanoma
T2 - updates in clinical practice
AU - Schvartsman, Gustavo
AU - Taranto, Patricia
AU - Glitza, Isabella C.
AU - Agarwala, Sanjiv S.
AU - Atkins, Michael B.
AU - Buzaid, Antonio C.
N1 - Publisher Copyright:
© The Author(s), 2019.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - 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.
AB - 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.
KW - BRAF inhibitor
KW - anti-PD-1
KW - combination immunotherapy
KW - immunotherapy
KW - melanoma
KW - metastatic brain tumors
KW - targeted therapy
KW - treatment sequencing
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U2 - 10.1177/1758835919851663
DO - 10.1177/1758835919851663
M3 - Review article
C2 - 31205512
AN - SCOPUS:85067672067
SN - 1758-8340
VL - 11
JO - Therapeutic Advances in Medical Oncology
JF - Therapeutic Advances in Medical Oncology
ER -