Patients with in‐transit melanoma metastases have comparable survival outcomes following isolated limb infusion or intralesional PV‐10—A propensity score matched, single center study

Read, Tavis; Fayers, Warren; Thomas, Janine; Wagels, Michael; Barbour, Andrew P.; Smithers, B. Mark

doi:10.1002/jso.25373

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…The nuances of these treatments and the associated survival outcomes of patient subgroups within the same cohort have been reported in greater detail elsewhere and are expanded on in the following chapters (Chapters 4 -7). (118,129,130,210) Finally, the influence of systemic therapy on patient survival is difficult to interpret, as until recently there were no effective options available.…”

Section: Nb Procedures Involving Selective Lymphadenectomy Including Sentinel Lymph Node Biopsy (Slnb)mentioning

confidence: 99%

An evaluation of the role of locoregional treatments for the management of in-transit melanoma metastases

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In-transit melanoma metastases are a well-recognised clinical phenomenon. The disease affects a heterogeneous group of patients and encompasses a broad phenotype. While frequently characterised by a recalcitrant pattern of disease progression, patients have a variable natural history. Locoregional recurrence has traditionally been considered to portend adverse survival. However, evidence suggests that a subset of patients experience prolonged disease-specific survival and instead, face challenges secondary to quality of life. These detrimental effects may be related to treatment or the disease. Moreover, the unpredictable clinical behaviour and need for less invasive and locally administered options has led to the development of numerous therapies. Recently, locoregional treatments have gained popularity as potentially efficacious alternatives with limited toxicity and morbidity profiles relative to more aggressive strategies.Despite the multitude of therapies reported in the literature, there remains a paucity of evidence concerning treatment selection and the long-term survival outcomes of patients within large, well-defined cohorts.Consequently, there is a lack of consensus governing the management of this disease. Additional data are required to characterise this cohort of patients and describe the therapeutic benefits of the various treatments available. Patient and disease factors that can be used to select therapy must also be identified.Further, with the earlier implementation of systemic agents for metastatic disease, the effects of novel immunotherapies and the continuing role for locoregional treatments within this group need to be clearly defined. Given the complexity in clinical decision making, this thesis seeks to concisely describe the outcomes of patients, in terms of locoregional treatment effects and survival, while identifying prognostic indicators that can be used to guide subsequent care.A structured, quantitative review of the literature was undertaken to appraise existing evidence for locoregional treatments in Australia. This was followed by a retrospective review of patients treated with this condition at a single institution. A series of studies were then performed to examine the use of PV-10, radiotherapy, isolated limb infusion, and diphenylcyclopropenone for the treatment of patients with in-transit disease. Next, a phase II, prospective, randomised, pilot study was established to compare two topical immunotherapeutic agents: imiquimod and diphenylcyclopropenone for the selective treatment of epidermotropic metastases. A case report is presented highlighting the benefit of a sequential, multimodal treatment strategy for the management of in-transit melanoma. Finally, a subgroup of patients was treated using systemic anti-PD-1 immunotherapy and an analysis was performed to characterise the role of such treatments within this cohort.The treatment of this disease has rapidly evolved with a transition from radical surgical intervention to more conservative measures. This contemporary app...

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Section: Nb Procedures Involving Selective Lymphadenectomy Including Sentinel Lymph Node Biopsy (Slnb)mentioning

confidence: 99%

An evaluation of the role of locoregional treatments for the management of in-transit melanoma metastases

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Novel Targets in Melanoma

Gingrich

Kirane

2020

Surgical Oncology Clinics of North America

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Patients with in‐transit melanoma metastases have comparable survival outcomes following isolated limb infusion or intralesional PV‐10—A propensity score matched, single center study

Cited by 2 publications

References 30 publications

An evaluation of the role of locoregional treatments for the management of in-transit melanoma metastases

An evaluation of the role of locoregional treatments for the management of in-transit melanoma metastases

Novel Targets in Melanoma

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