Complex treatment of melanoma

02/2019

MUDr. Ondřej Kodet, Ph.D.^1,2,3, MUDr. Ivana Krajsová, MBA¹

1. Dermatoveneroíogická klinika 1. LF UK a VFN, Praha

2. Anatomický ústav 1. LF UK, Praha

3. BIOCEV - Biotechnologické a biomedicínské centrum AV ČR a UK, Vestec u Prahy

SUMMARY

Melanoma is probably the most malignant skin cancer. Its incidence has increased significantly five times for the past 40 years, although mortality has been rather stationary in recent years. Complex treatment of melanoma is radical surgery, adjuvant therapy, and therapy of metastatic melanoma. The basis of therapy remains a radical surgery with a sufficient resection margin and histological examination of Breslow and, possibly examination of sentinel lymph node. In adjuvant therapy, checkpoint inhibitors are being used more recently, but currently only interferon alpha is approved. Therapy of metastatic melanoma has made great progress, and now it represents by BRAF and MEK inhibitors as targeted therapy, and immunooncology therapy using a checkpoint inhibitor, especially anti-PD-1. The newly introduced combined treatment options, immunotherapy, and combination with target therapy, are particularly prone to possible higher toxicity. More recently, oncolytic viruses have been used in combination with checkpoint inhibitors. New approaches to complex melanoma therapy have brought major advances that have significantly affected the prognosis of patients with melanoma.

Key words

melanoma, metastatic melanoma, targeted therapy, immunotherapy, BRAF mutation, anti-PD-1