Neoadjuvant treatment for stage III and IV cutaneous melanoma

Gorry, Claire; McCullagh, Laura; O'Donnell, Helen; Barrett, Sarah; Schnittger, Susanne; Barry, Michael; Curtin, Kay; Beausang, E.; Barry, Rupert; Coyne, Imelda

doi:10.1002/14651858.cd012974.pub2

Cited by 11 publications

(6 citation statements)

References 158 publications

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“…Some authors reported promising results for neoadjuvant therapies such as immunomodulators [62,65] or BRAF/MEK inhibitors [66]. However, neoadjuvant therapy was also associated with considerable adverse effects [62,67], and a recent systematic review found no certain benefits of neoadjuvant therapy in advanced cutaneous melanomas [68].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Clinical and Histopathological Factors on Disease Progression and Survival in Thick Cutaneous Melanomas

Țăpoi,

Derewicz,

Gheorghișan-Gălățeanu

et al. 2023

Biomedicines

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Thick cutaneous melanomas (Breslow depth > 4 mm) are locally advanced tumors, generally associated with poor prognosis. Nevertheless, these tumors sometimes display unpredictable behavior. This study aims to analyze clinical and histopathological features that can influence the prognosis of thick melanomas. This is a retrospective study on 94 thick primary cutaneous melanomas diagnosed between 2012 and 2018 that were followed-up for at least five years to assess disease progression and survival. We evaluated the age, gender, tumor location, histological subtype, Breslow depth, Clark level, resection margins, mitotic index, the presence/absence of ulceration, necrosis, regression, microsatellites, neurotropism, lymphovascular invasion, and the pattern of tumor-infiltrating lymphocytes, and their association with disease progression and survival. By conducting univariate analysis, we found that progression-free survival (PFS) was significantly associated with female gender, the superficial spreading melanoma (SSM) subtype, mitotic index, necrosis, microsatellites, and perineural invasion. Overall survival (OS) was significantly associated with female gender, Breslow depth, SSM subtype, necrosis, microsatellites, and perineural invasion. Through multivariate Cox proportional hazards regression, we found that the only factors associated with PFS were Breslow depth, necrosis, microsatellites, and perineural invasion, while the factors associated with OS were Breslow depth, necrosis, microsatellites, and perineural invasion. Certain histopathological features such as Breslow depth, necrosis, microsatellites, and perineural invasion could explain differences in disease evolution. This is one of the first studies to demonstrate an association between necrosis and perineural invasion and outcomes in patients with thick melanomas. By identifying high-risk patients, personalized therapy can be provided for improved prognosis.

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Section: Discussionmentioning

confidence: 99%

The Impact of Clinical and Histopathological Factors on Disease Progression and Survival in Thick Cutaneous Melanomas

Țăpoi,

Derewicz,

Gheorghișan-Gălățeanu

et al. 2023

Biomedicines

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“…Several phase I and II clinical trials have been performed in melanoma patients treated with Qβ-VLPs loaded with A-type CpGs (G10) (GMP-001), which does not contain any tumor antigen, as monotherapy or in combination with anti-PD-1 check-point inhibitors, and the results showed promising clinical activity (NCT02680184, NCT03084640, and NCT03618641) [ 156 , 157 , 158 ].…”

Section: Vlp Cancer Vaccines In Melanoma Treatmentmentioning

confidence: 99%

Virus-like Particle (VLP) Vaccines for Cancer Immunotherapy

Ruzzi,

Semprini,

Scalambra

et al. 2023

IJMS

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Cancer vaccines are increasingly being studied as a possible strategy to prevent and treat cancers. While several prophylactic vaccines for virus-caused cancers are approved and efficiently used worldwide, the development of therapeutic cancer vaccines needs to be further implemented. Virus-like particles (VLPs) are self-assembled protein structures that mimic native viruses or bacteriophages but lack the replicative material. VLP platforms are designed to display single or multiple antigens with a high-density pattern, which can trigger both cellular and humoral responses. The aim of this review is to provide a comprehensive overview of preventive VLP-based vaccines currently approved worldwide against HBV and HPV infections or under evaluation to prevent virus-caused cancers. Furthermore, preclinical and early clinical data on prophylactic and therapeutic VLP-based cancer vaccines were summarized with a focus on HER-2-positive breast cancer.

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“…The Cochrane meta-analysis of neoadjuvant clinical trials in melanoma patients did not support the neoadjuvant approach, but since it was carried out, new evidence has emerged in favor of the superior efficacy of the neoadjuvant over the adjuvant approach [ 20 ]. The phase II randomized trial, SWOG 1801, compared the adjuvant and neoadjuvant immunotherapy strategies head to head.…”

Section: Introductionmentioning

confidence: 99%

Molecular and Clinicopathological Biomarkers in the Neoadjuvant Treatment of Patients with Advanced Resectable Melanoma

Błoński,

Czarnecka,

Ostaszewski

et al. 2024

Biomedicines

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Neoadjuvant systemic therapy is emerging as the best medical practice in patients with resectable stage III melanoma. As different regimens are expected to become available in this approach, the improved optimization of treatment strategies is required. Personalization of care in each individual patient—by precisely determining the disease-related risk and the most efficient therapeutic approach—is expected to minimize disease recurrence, but also the incidence of treatment-related adverse events and the extent of surgical intervention. This can be achieved through validation and clinical application of predictive and prognostic biomarkers. For immune checkpoint inhibitors, there are no validated predictive biomarkers until now. Promising predictive molecular biomarkers for neoadjuvant immunotherapy are tumor mutational burden and the interferon-gamma pathway expression signature. Pathological response to neoadjuvant treatment is a biomarker of a favorable prognosis and surrogate endpoint for recurrence-free survival in clinical trials. Despite the reliability of these biomarkers, risk stratification and response prediction in the neoadjuvant setting are still unsatisfactory and represent a critical knowledge gap, limiting the development of optimized personalized strategies in everyday practice.

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Neoadjuvant treatment for stage III and IV cutaneous melanoma

Cited by 11 publications

References 158 publications

The Impact of Clinical and Histopathological Factors on Disease Progression and Survival in Thick Cutaneous Melanomas

The Impact of Clinical and Histopathological Factors on Disease Progression and Survival in Thick Cutaneous Melanomas

Virus-like Particle (VLP) Vaccines for Cancer Immunotherapy

Molecular and Clinicopathological Biomarkers in the Neoadjuvant Treatment of Patients with Advanced Resectable Melanoma

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