European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2019
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články
PubMed
31866016
DOI
10.1016/j.ejca.2019.11.015
PII: S0959-8049(19)30834-2
Knihovny.cz E-zdroje
- Klíčová slova
- Adjuvant treatment, Cutaneous melanoma, Excisional margins, Interferon-α, Metastasectomy, Sentinel lymph node dissection, Systemic treatment, Tumour thickness,
- MeSH
- diagnostické zobrazování normy MeSH
- Evropská unie MeSH
- kombinovaná terapie MeSH
- konsensus MeSH
- lidé MeSH
- melanom klasifikace diagnóza terapie MeSH
- mezioborová komunikace * MeSH
- směrnice pro lékařskou praxi jako téma normy MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
A unique collaboration of multidisciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization for Research and Treatment of Cancer (EORTC) was formed to make recommendations on cutaneous melanoma diagnosis and treatment, based on systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with 1- to 2-cm safety margins. Sentinel lymph node dissection shall be performed as a staging procedure in patients with tumour thickness ≥1.0 mm or ≥0.8 mm with additional histological risk factors, although there is as yet no clear survival benefit for this approach. Therapeutic decisions in stage III/IV patients should be primarily made by an interdisciplinary oncology team ("Tumor Board"). Adjuvant therapies in stage III/IV patients are primarily anti-PD-1, independent of mutational status, or dabrafenib plus trametinib for BRAF-mutant patients. In distant metastasis, either resected or not, systemic treatment is indicated. For first-line treatment, particularly in BRAF wild-type patients, immunotherapy with PD-1 antibodies alone or in combination with CTLA-4 antibodies shall be considered. In particular scenarios for patients with stage IV melanoma and a BRAF-V600 E/K mutation, first-line therapy with BRAF/MEK inhibitors can be offered as an alternative to immunotherapy. In patients with primary resistance to immunotherapy and harbouring a BRAF-V600 E/K mutation, this therapy shall be offered in second-line. Systemic therapy in stage III/IV melanoma is a rapidly changing landscape, and it is likely that these recommendations may change in the near future.
1st Department of Dermatology Aristotle University Thessaloniki Greece
Center for Dermatooncology Department of Dermatology Eberhard Karls University Tuebingen Germany
Department of Dermatology Erasme Hospital Université Libre de Bruxelles Brussels Belgium
Department of Dermatology Medical University of Vienna Austria
Department of Dermatology University Hospital Schleswig Holstein Campus Kiel Kiel Germany
Department of Dermatology University of L'Aquila Italy
Department of Dermatology Venerology and Allergology Frankfurt University Hospital Frankfurt Germany
Department of Oncology Odense University Hospital Denmark
Dermatology Clinic Maggiore Hospital University of Trieste Trieste Italy
Dermatology Department CHU Nantes CIC 1413 CRCINA University Nantes Nantes France
Dermatology Unit University of Modena and Reggio Emilia Modena Italy
Medical and Surgical Dermatology Service Hospital Universitario Virgen Macarena Sevilla Spain
Melanoma Unit Department of Dermatology Hospital Clinic IDIBAPS Barcelona Spain
NIHR Biomedical Research Centre University of Oxford UK
Princess Máxima Center 3584 CS Utrecht the Netherlands
Citace poskytuje Crossref.org
