A Population Based Comparison of the AJCC 7th And AJCC 8th Editions for Patients Diagnosed With Stage III Cutaneous Malignant Melanoma in Sweden.

Isaksson, Karolin; Katsarelias, Dimitrios; Mikiver, Rasmus; Carneiro, Ana; Ny, Lars; Bagge, Roger Olofsson

doi:10.1016/j.ejso.2019.11.342

Cited by 6 publications

(13 citation statements)

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“…A Swedish population-based registry reported 5-and 10-year MSS rates of 87% and 80%, respectively, for stage IIIA disease. 62 Similarly, a German study reported a 5-year MSS rate of 89% for stage IIIA disease. 63 Other groups are reviewing their data and further publications are expected.…”

Section: Annals Of Oncologymentioning

confidence: 96%

ESMO consensus conference recommendations on the management of locoregional melanoma: under the auspices of the ESMO Guidelines Committee

Michielin¹,

Akkooi

Lorigan

et al. 2020

Annals of Oncology

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The European Society for Medical Oncology (ESMO) held a consensus conference on melanoma on 5e7 September 2019 in Amsterdam, The Netherlands. The conference included a multidisciplinary panel of 32 leading experts in the management of melanoma. The aim of the conference was to develop recommendations on topics that are not covered in detail in the current ESMO Clinical Practice Guideline and where available evidence is either limited or conflicting. The main topics identified for discussion were: (i) the management of locoregional disease; (ii) targeted versus immunotherapies in the adjuvant setting; (iii) targeted versus immunotherapies for the first-line treatment of metastatic melanoma; (iv) when to stop immunotherapy or targeted therapy in the metastatic setting; and (v) systemic versus local treatment of brain metastases. The expert panel was divided into five working groups in order to each address questions relating to one of the five topics outlined above. Relevant scientific literature was reviewed in advance. Recommendations were developed by the working groups and then presented to the entire panel for further discussion and amendment before voting. This manuscript presents the results relating to the management of locoregional melanoma, including findings from the expert panel discussions, consensus recommendations and a summary of evidence supporting each recommendation. All participants approved the final manuscript.

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Section: Annals Of Oncologymentioning

confidence: 96%

ESMO consensus conference recommendations on the management of locoregional melanoma: under the auspices of the ESMO Guidelines Committee

Michielin¹,

Akkooi

Lorigan

et al. 2020

Annals of Oncology

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“…5 When considering this relative risk on the current data presented for the Swedish stage IIIA population, the absolute gain in survival at 5 years would be 6.4% using the AJCC 7th edition, compared with 3.6% using the AJCC 8th edition, increasing the number needed to treat from approximately 17-25 patients. 3 These findings highlight the importance of analysing new adjuvant melanoma trials in light of the new AJCC 8th edition, especially when overall survival data for the modern adjuvant trials are published.…”

Section: Futurementioning

confidence: 97%

“…A recent publication using a prospective population-based registry including all Swedish patients with melanoma showed an improved 5-and 10-year melanoma-specific survival (MSS) for substages IIIA, IIIB, and IIIC when patients were reclassified according to the updated AJCC 8th edition, while the new substage IIID had the worst prognosis. 3…”

Section: Presentmentioning

confidence: 99%

ASO Author Reflections: Effects of the Updated AJCC Classification for Patients with Stage III Melanoma

2019

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PASTThe incidence of cutaneous melanoma is steadily increasing in most countries with fair-skin populations. According to the American Joint Committee on Cancer (AJCC) staging manual, patients with satellite/in-transit metastasis and/or regional lymph node disease are classified as stage III melanoma, which is further divided into subgroups according to prognosis. The AJCC 7th edition was recently replaced with the updated AJCC 8th edition, and the number of subgroups in stage III were revised from three (A-C) to four (A-D) groups. 1 The subgroup classification now depends on both T and N status, and the previous low-risk group (stage IIIA) has an even better prognosis, while patients with the highest risk are now classified as stage IIID. This substage migration can have an impact on the clinical management of patients with stage III melanoma. PRESENTCurrently, there is a paradigm shift with the introduction of new effective systemic treatments for patients with both stage III and IV disease. Three immune checkpoint inhibitors have been approved for use in advanced melanoma, i.e. the CTLA-4 inhibitor ipilimumab and the PD-1 inhibitors nivolumab and pembrolizumab. In addition, targeted therapies (BRAF/MEK inhibitors) are also available as a treatment for patients with BRAF-mutated melanomas. Adjuvant trials have recently shown a relapse-free survival (RFS) benefit of systemic treatment in stage III melanoma, leading to a change in therapeutic approach for stage III patients after radical surgery; 2 however, all these adjuvant trials were performed using the former AJCC 7th edition for stage classification. A recent publication using a prospective population-based registry including all Swedish patients with melanoma showed an improved 5-and 10-year melanoma-specific survival (MSS) for substages IIIA, IIIB, and IIIC when patients were reclassified according to the updated AJCC 8th edition, while the new substage IIID had the worst prognosis. 3 FUTUREA recent update from one of the adjuvant trials (the EORTC1325/KEYNOTE-054 trial) showed that only 8% of patients would be classified as stage IIIA according to the AJCC 8th edition, compared with 15% according to the AJCC 7th edition used in the trial. Moreover, this analysis showed that when reclassifying patients according to the AJCC 8th edition, the 1-year recurrence-free survival in the stage IIIA subgroup was 92.7% versus 92.5% in the placebo arm. 4 These differences based on substage migration ASO Author Reflections is a brief invited commentary on the article ''A Population-Based Comparison of the AJCC 7th and AJCC 8th Editions for Patients Diagnosed with Stage III Cutaneous Malignant

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“…an early diagnosis [2,3] [ Figure 1]. Furthermore, the age-adjusted rate of new cases reported in the USA between 1999 and 2016 shows an important increase of new cases of melanoma per year with respect to others kinds of cancer such as lung, breast, and colon cancers [ Figure 1].…”

mentioning

confidence: 99%

“…Furthermore, the age-adjusted rate of new cases reported in the USA between 1999 and 2016 shows an important increase of new cases of melanoma per year with respect to others kinds of cancer such as lung, breast, and colon cancers [ Figure 1]. The overall survival is higher in the case of localized disease, but patients with metastatic melanoma show a very poor prognosis, with a median survival rate ranging 3-6 months [2][3][4] . While low-grade primary tumors are usually successfully treated by surgical excision, systemic treatment of advanced metastatic disease treated with chemotherapy shows a low response rate and generally no overall survival rate improvement [5] .…”

mentioning

confidence: 99%

Cancer stem cells, plasticity, and drug resistance

Lionetti¹,

Fumagalli²,

Porta³

2020

CDR

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Melanoma is a highly aggressive tumor and almost always fatal when metastatic. Herein, we discuss recent findings on the mechanisms of resistance of human cutaneous melanoma. To achieve a precision medicine approach, the heterogeneity and plasticity of tumor cells are two crucial aspects to be investigated in depth. In fact, to understand the mechanisms that cells use to acquire a resistant phenotype after chemotherapy or how resistant cells inside the tumor are selected, it is the most important issue for a successful therapy. Since new therapeutic strategies are trying to go in this direction, we discuss here the state of the art of the research and the clinical impact of these strategies. We also discuss and suggest future research directions to develop approaches able to define the best concentration and time of exposure of the drug or the cocktails of drugs for each specific patient based on his/her biological features.Melanoma arises from mutated melanocytes, the pigment producing cells. Although melanoma is a rare tumor, occurring in about 1% of all skin malignant tumors, it represents almost 2% of all cancer deaths worldwide [1] ; the survival rate is strictly related to the stage of the tumor and thus to the ability to perform

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A Population Based Comparison of the AJCC 7th And AJCC 8th Editions for Patients Diagnosed With Stage III Cutaneous Malignant Melanoma in Sweden.

Cited by 6 publications

References 0 publications

ESMO consensus conference recommendations on the management of locoregional melanoma: under the auspices of the ESMO Guidelines Committee

ESMO consensus conference recommendations on the management of locoregional melanoma: under the auspices of the ESMO Guidelines Committee

ASO Author Reflections: Effects of the Updated AJCC Classification for Patients with Stage III Melanoma

Cancer stem cells, plasticity, and drug resistance

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