Managing in-transit melanoma metastases in the new era of effective systemic therapies for melanoma.

Managing in-transit melanoma metastases in the new era of effective systemic therapies for melanoma.

Publication date: Nov 05, 2019

Introduction: Melanoma in-transit metastases (ITMs) occur between the primary tumor site and the regional node field. Most patients with ITMs have a poor prognosis. The treatment of ITMs can be simple if surgical excision is possible, but challenging when ITMs are advanced, multiple or recurrent and impacting quality of life.Areas covered: The management of ITM is still evolving. Patients who are disease-free after surgical excision of ITMs are today candidates for adjuvant systemic treatment to reduce recurrence risk. Some who have multiple or advanced ITMs may achieve long-term survival or disease control with systemic therapies alone. Those who do not remain candidates for the numerous locoregional therapies used to treat ITMs, including electrocautery, intralesional injection, topical therapy, electrochemotherapy, isolated limb infusion, isolated limb perfusion, radiation therapy and, rarely, amputation. Relevant publications identified in Pubmed and MEDLINE databases are reviewed.Expert opinion: Patients with multiple ITMs can benefit from use of systemic therapies as primary treatment, in the adjuvant setting and in neoadjuvant trials. Multiple alternative treatment modalities exist for patients unsuitable for systemic therapies or in whom systemic therapies have failed. Trials assessing combined systemic and locoregional therapies for ITMs are in progress.

Read, R.L. and Thompson, J.F. Managing in-transit melanoma metastases in the new era of effective systemic therapies for melanoma. 24703. 2019 Expert Rev Clin Pharmacol.

Concepts Keywords
Adjuvant Transit melanoma metastases
Amputation Therapy melanoma
Electrocautery Tumor
Infusion Disease
MEDLINE Radiation therapy
Melanoma Electrocautery
Metastases Amputation
Neoadjuvant Electrochemotherapy
Primary Tumor Health
Prognosis Medicine
Pubmed Cancer treatments
Radiation Therapy Melanoma
Topical Antineoplastic drugs
Transit RTT
Therapy
Limb perfusion
Chemotherapy
Radiation therapy
Neoadjuvant therapy
Radiation

Semantics

Type Source Name
disease MESH melanoma
disease DOID melanoma
pathway BSID Melanoma
disease MESH metastases
disease MESH tumor
gene UNIPROT LITAF
gene UNIPROT SLC22A18
drug DRUGBANK Nonoxynol-9
disease MESH recurrence

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