Management options for metastatic melanoma in the era of novel therapies: A primer for the practicing dermatologist

Fox, Matthew C.; Lao, Christopher D.; Schwartz, Jennifer; Frohm, Marcus L.; Bichakjian, Christopher K.; Johnson, Timothy M.

doi:10.1016/j.jaad.2012.09.040

Cited by 13 publications

(7 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In fact, other drugs tolerated were: ibuprofen, clarithromycin, amoxicillin, metamizole, tramadol, ketoprofen, metoclopramide, rituximab, lercanidipine, echinocandin, teicoplanin, haloperidoland meropenem. In our patients, we discontinued the culprit drug and administered steroid therapy at high dosage, a treatment suggested in other studies [ 42 , 43 ]. High doses of steroid might have an immunosuppressive effect preventing a relapse due to other compounds [ 41 ].…”

Section: Discussionmentioning

confidence: 98%

Tolerated drugs in subjects with severe cutaneous adverse reactions (SCARs) induced by anticonvulsants and review of the literature

et al. 2017

View full text Add to dashboard Cite

BackgroundAnticonvulsant hypersensitivity syndrome represents a rare but potentially fatal kind of adverse drug reaction. This clinical picture often hampers the flexibility with which alternative anticonvulsants or even other classes of drugs are prescribed in these patients, negatively affecting the efficacy of treatment and the course of the disease. The aim of this study was to analyse a group of six patients with severe cutaneous drug reactions induced by anticonvulsants and to report which alternative antiepileptic drugs and which drugs of other classes were tolerated.Case presentationA total of six patients (2 males and 4 females, age 11–73 years) are described in this study. In all the patients the onset of the severe cutaneous drug reactions was 2–4 weeks after initiating the anticonvulsant therapy: 2 out of 6 patients presented with a drug reaction with eosinophilia and systemic symptoms under therapy with phenytoin; 2 out of 6 presented with Stevens–Johnson syndrome under therapy with lamotrigine; and 2 out of 6 presented with a toxic epidermal necrolysis, one of them under therapy with valproic acid, and the other one under therapy with lamotrigine. Alternative anticonvulsants tolerated after the reaction were: clonazepam, levetiracetam, diazepam, delorazepam and lormetazepam.ConclusionsIn our cases we observed that non aromatic anticonvulsants and benzodiazepines were well tolerated as alternative treatments in six patients with reactions to aromatic anticonvulsivants and that the risk of hypersensitivity reactions to other drug classes was not increased as compared to general population.

show abstract

Section: Discussionmentioning

confidence: 98%

Tolerated drugs in subjects with severe cutaneous adverse reactions (SCARs) induced by anticonvulsants and review of the literature

et al. 2017

View full text Add to dashboard Cite

show abstract

“…As in the case of our patient, surgical excision is the gold standard of treatment for melanoma but is often not feasible with metastases. Traditionally there have been few other alternatives, 5 but in recent years, the field of cancer immunotherapy has grown prodigiously. IL-2, thought to stimulate the body’s immune response, 6 is one such therapeutic used in the treatment of metastatic melanoma.…”

Section: Discussionmentioning

confidence: 99%

Unusual melanoma of the scalp with blue nevus-like features and local metastasis: A case report

George

Green

Walsh

2019

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

show abstract

“…In the fore front of these is a molecule that specifically inhibits the mutated BRAF V600E kinase, Vemurafenib, which was approved by the FDA in 2011 as a therapeutic option for treatment of unresectable metastatic melanoma (Chapman et al, 2011). Given the success of this treatment and other treatment advances detailed below, new guidelines for the treatment of melanoma are evolving (Fox et al, 2013). Moreover, deep sequencing analyses have revealed new potential targets and much has been learned about the molecular basis of melanoma genesis.…”

Section: Introductionmentioning

confidence: 99%

Advances in Personalized Targeted Treatment of Metastatic Melanoma and Non-Invasive Tumor Monitoring

Klinac¹,

Gray²,

Millward³

et al. 2013

Front. Oncol.

View full text Add to dashboard Cite

Despite extensive scientific progress in the melanoma field, treatment of advanced stage melanoma with chemotherapeutics and biotherapeutics has rarely provided response rates higher than 20%. In the past decade, targeted inhibitors have been developed for metastatic melanoma, leading to the advent of more personalized therapies of genetically characterized tumors. Here we review current melanoma treatments and emerging targeted molecular therapies. In particular we discuss the mutant BRAF inhibitors Vemurafenib and Dabrafenib, which markedly inhibit tumor growth and advance patients’ overall survival. However this response is almost inevitably followed by complete tumor relapse due to drug resistance hampering the encouraging initial responses. Several mechanisms of resistance within and outside the MAPK pathway have now been uncovered and have paved the way for clinical trials of combination therapies to try and overcome tumor relapse. It is apparent that personalized treatment management will be required in this new era of targeted treatment. Circulating tumor cells (CTCs) provide an easily accessible means of monitoring patient relapse and several new approaches are available for the molecular characterization of CTCs. Thus CTCs provide a monitoring tool to evaluate treatment efficacy and early detection of drug resistance in real time. We detail here how advances in the molecular analysis of CTCs may provide insight into new avenues of approaching therapeutic options that would benefit personalized melanoma management.

show abstract

Management options for metastatic melanoma in the era of novel therapies: A primer for the practicing dermatologist

Cited by 13 publications

References 44 publications

Tolerated drugs in subjects with severe cutaneous adverse reactions (SCARs) induced by anticonvulsants and review of the literature

Tolerated drugs in subjects with severe cutaneous adverse reactions (SCARs) induced by anticonvulsants and review of the literature

Unusual melanoma of the scalp with blue nevus-like features and local metastasis: A case report

Advances in Personalized Targeted Treatment of Metastatic Melanoma and Non-Invasive Tumor Monitoring

Contact Info

Product

Resources

About