Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Melanoma: HELP
Articles by Daniel G. Coit
Based on 41 articles published since 2009
(Why 41 articles?)
||||

Between 2009 and 2019, D. G. Coit wrote the following 41 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline NCCN Guidelines Insights: Melanoma, Version 3.2016. 2016

Coit, Daniel G / Thompson, John A / Algazi, Alain / Andtbacka, Robert / Bichakjian, Christopher K / Carson, William E / Daniels, Gregory A / DiMaio, Dominick / Fields, Ryan C / Fleming, Martin D / Gastman, Brian / Gonzalez, Rene / Guild, Valerie / Johnson, Douglas / Joseph, Richard W / Lange, Julie R / Martini, Mary C / Materin, Miguel A / Olszanski, Anthony J / Ott, Patrick / Gupta, Aparna Priyanath / Ross, Merrick I / Salama, April K / Skitzki, Joseph / Swetter, Susan M / Tanabe, Kenneth K / Torres-Roca, Javier F / Trisal, Vijay / Urist, Marshall M / McMillian, Nicole / Engh, Anita. ·From Memorial Sloan Kettering Cancer Center; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance; UCSF Helen Diller Family Comprehensive Cancer Center; Huntsman Cancer Institute at the University of Utah; University of Michigan Comprehensive Cancer Center; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute; UC San Diego Moores Cancer Center; Fred & Pamela Buffett Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; The University of Tennessee Health Science Center; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute; University of Colorado Cancer Center; Aim at Melanoma; Vanderbilt-Ingram Cancer Center; Mayo Clinic Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Yale Cancer Center/Smilow Cancer Hospital; Fox Chase Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The University of Texas MD Anderson Cancer Center; Duke Cancer Institute; Roswell Park Cancer Institute; Stanford Cancer Institute; Massachusetts General Hospital Cancer Center; Moffitt Cancer Center; City of Hope Comprehensive Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; and National Comprehensive Cancer Network. ·J Natl Compr Canc Netw · Pubmed #27496110.

ABSTRACT: The NCCN Guidelines for Melanoma have been significantly revised over the past few years in response to emerging data on a number of novel agents and treatment regimens. These NCCN Guidelines Insights summarize the data and rationale supporting extensive changes to the recommendations for systemic therapy in patients with metastatic or unresectable melanoma.

2 Guideline Melanoma, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology. 2016

Coit, Daniel G / Thompson, John A / Algazi, Alain / Andtbacka, Robert / Bichakjian, Christopher K / Carson, William E / Daniels, Gregory A / DiMaio, Dominick / Ernstoff, Marc / Fields, Ryan C / Fleming, Martin D / Gonzalez, Rene / Guild, Valerie / Halpern, Allan C / Hodi, F Stephen / Joseph, Richard W / Lange, Julie R / Martini, Mary C / Materin, Miguel A / Olszanski, Anthony J / Ross, Merrick I / Salama, April K / Skitzki, Joseph / Sosman, Jeff / Swetter, Susan M / Tanabe, Kenneth K / Torres-Roca, Javier F / Trisal, Vijay / Urist, Marshall M / McMillian, Nicole / Engh, Anita. · ·J Natl Compr Canc Netw · Pubmed #27059193.

ABSTRACT: This selection from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Melanoma focuses on adjuvant therapy and treatment of in-transit disease, because substantial changes were made to the recommendations for the 2016 update. Depending on the stage of the disease, options for adjuvant therapy now include biochemotherapy and high-dose ipilimumab. Treatment options for in-transit disease now include intralesional injection with talimogene laherparepvec (T-VEC), a new immunotherapy. These additions prompted re-assessment of the data supporting older recommended treatment options for adjuvant therapy and in-transit disease, resulting in extensive revisions to the supporting discussion sections.

3 Guideline Melanoma, version 4.2014. 2014

Coit, Daniel G / Thompson, John A / Andtbacka, Robert / Anker, Christopher J / Bichakjian, Christopher K / Carson, William E / Daniels, Gregory A / Daud, Adil / Dimaio, Dominick / Fleming, Martin D / Gonzalez, Rene / Guild, Valerie / Halpern, Allan C / Hodi, F Stephen / Kelley, Mark C / Khushalani, Nikhil I / Kudchadkar, Ragini R / Lange, Julie R / Martini, Mary C / Olszanski, Anthony J / Ross, Merrick I / Salama, April / Swetter, Susan M / Tanabe, Kenneth K / Trisal, Vijay / Urist, Marshall M / McMillian, Nicole R / Ho, Maria / Anonymous3691481. ·From 1Memorial Sloan-Kettering Cancer Center; 2Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance; 3Huntsman Cancer Institute at the University of Utah; 4University of Michigan Comprehensive Cancer Center; 5The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute; 6UC San Diego Moores Cancer Center; 7UCSF Helen Diller Family Comprehensive Cancer Center; 8Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; 9St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; 10University of Colorado Cancer Center; 11Aim at Melanoma; 12Dana-Farber/Brigham and Women's Cancer Center; 13Vanderbilt-Ingram Cancer Center; 14Roswell Park Cancer Institute; 15Moffitt Cancer Center; 16The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; 17Robert H. Lurie Comprehensive Cancer Center of Northwestern University; 18Fox Chase Cancer Center; 19The University of Texas MD Anderson Cancer Center; 20Duke Cancer Institute; 21Stanford Cancer Institute; 22Massachusetts General Hospital Cancer Center; 23City of Hope Comprehensive Cancer Center; 24University of Alabama at Birmingham Comprehensive Cancer Center; and 25National Comprehensive Cancer Network. ·J Natl Compr Canc Netw · Pubmed #24812131.

ABSTRACT: The NCCN Guidelines for Melanoma provide multidisciplinary recommendations for the management of patients with melanoma. These NCCN Guidelines Insights highlight notable recent updates. Dabrafenib and trametinib, either as monotherapy (category 1) or combination therapy, have been added as systemic options for patients with unresectable metastatic melanoma harboring BRAF V600 mutations. Controversy continues regarding the value of adjuvant radiation for patients at high risk of nodal relapse. This is reflected in the category 2B designation to consider adjuvant radiation following lymphadenectomy for stage III melanoma with clinically positive nodes or recurrent disease.

4 Guideline Melanoma, version 2.2013: featured updates to the NCCN guidelines. 2013

Coit, Daniel G / Andtbacka, Robert / Anker, Christopher J / Bichakjian, Christopher K / Carson, William E / Daud, Adil / Dimaio, Dominick / Fleming, Martin D / Guild, Valerie / Halpern, Allan C / Hodi, F Stephen / Kelley, Mark C / Khushalani, Nikhil I / Kudchadkar, Ragini R / Lange, Julie R / Lind, Anne / Martini, Mary C / Olszanski, Anthony J / Pruitt, Scott K / Ross, Merrick I / Swetter, Susan M / Tanabe, Kenneth K / Thompson, John A / Trisal, Vijay / Urist, Marshall M / McMillian, Nicole / Ho, Maria / Anonymous3071481. ·Memorial Sloan-Kettering Cancer Center. ·J Natl Compr Canc Netw · Pubmed #23584343.

ABSTRACT: The NCCN Guidelines for Melanoma provide multidisciplinary recommendations on the clinical management of patients with melanoma. This NCCN Guidelines Insights report highlights notable recent updates. Foremost of these is the exciting addition of the novel agents ipilimumab and vemurafenib for treatment of advanced melanoma. The NCCN panel also included imatinib as a treatment for KIT-mutated tumors and pegylated interferon alfa-2b as an option for adjuvant therapy. Also important are revisions to the initial stratification of early-stage lesions based on the risk of sentinel lymph node metastases, and revised recommendations on the use of sentinel lymph node biopsy for low-risk groups. Finally, the NCCN panel reached clinical consensus on clarifying the role of imaging in the workup of patients with melanoma.

5 Guideline Melanoma. 2012

Coit, Daniel G / Andtbacka, Robert / Anker, Christopher J / Bichakjian, Christopher K / Carson, William E / Daud, Adil / Dilawari, Raza A / Dimaio, Dominick / Guild, Valerie / Halpern, Allan C / Hodi, F Stephen / Kelley, Mark C / Khushalani, Nikhil I / Kudchadkar, Ragini R / Lange, Julie R / Lind, Anne / Martini, Mary C / Olszanski, Anthony J / Pruitt, Scott K / Ross, Merrick I / Swetter, Susan M / Tanabe, Kenneth K / Thompson, John A / Trisal, Vijay / Urist, Marshall M / Anonymous2531481. · ·J Natl Compr Canc Netw · Pubmed #22393197.

ABSTRACT: -- No abstract --

6 Guideline Melanoma. 2009

Coit, Daniel G / Andtbacka, Robert / Bichakjian, Christopher K / Dilawari, Raza A / Dimaio, Dominick / Guild, Valerie / Halpern, Allan C / Hodi, F Stephen / Kashani-Sabet, Mohammed / Lange, Julie R / Lind, Anne / Martin, Lainie / Martini, Mary C / Pruitt, Scott K / Ross, Merrick I / Sener, Stephen F / Swetter, Susan M / Tanabe, Kenneth K / Thompson, John A / Trisal, Vijay / Urist, Marshall M / Weber, Jeffrey / Wong, Michael K / Anonymous81481. · ·J Natl Compr Canc Netw · Pubmed #19401060.

ABSTRACT: -- No abstract --

7 Editorial Is pediatric melanoma always malignant? 2013

Coit, Daniel G / Ernstoff, Marc S / Busam, Klaus J. ·Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York. ·Cancer · Pubmed #24022827.

ABSTRACT: -- No abstract --

8 Editorial Is a "Merkel" just like a melanoma? The pathologic analysis of Merkel cell carcinoma specimens. 2012

Fields, Ryan C / Coit, Daniel G. · ·Ann Surg Oncol · Pubmed #22875643.

ABSTRACT: -- No abstract --

9 Editorial The challenge of defining guidelines for sentinel lymph node biopsy in patients with thin primary cutaneous melanomas. 2012

Gershenwald, Jeffrey E / Coit, Daniel G / Sondak, Vernon K / Thompson, John F. · ·Ann Surg Oncol · Pubmed #22868918.

ABSTRACT: -- No abstract --

10 Review Progress in the management of melanoma in 2013. 2013

Coit, Daniel G / Olszanski, Anthony J. ·Melanoma Disease Management Team at Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA. coitd@mskcc.org ·J Natl Compr Canc Netw · Pubmed #23704234.

ABSTRACT: The treatment of melanoma in 2013 has evolved significantly over the past 2 years, according to presentations at the recent NCCN 18th Annual Conference. Ipilimumab and vemurafenib have prolonged the survival of patients with advanced disease, and the research pipeline continues to evaluate a number of new agents highlighting a tremendous optimism to further improve outcomes. These new treatment options were incorporated into the NCCN Clinical Practice Guidelines in Oncology in 2012. A recent presentation of these guidelines highlighted changes in both the initial management of very thin melanomas and the ongoing importance of targeted agents and immunotherapy in more advanced disease. This presentation included refining the indication for sentinel lymph node biopsy (SLNB), which, according to the updated guidelines, is not recommended for very thin lesions (≤ 0.75 mm). Dr. Daniel G. Coit discussed the rationale for this change during the presentation, and Dr. Anthony J. Olszanski reviewed the evidence for new classes of agents that impact survival.

11 Review Evidence-based follow-up for the patient with melanoma. 2011

Fields, Ryan C / Coit, Daniel G. ·Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. ·Surg Oncol Clin N Am · Pubmed #21111966.

ABSTRACT: This article reviews the best evidence available to guide the follow-up of patients with melanoma, focusing on incidence of, and detection of, melanoma recurrence, frequency of follow-up visits, yield of, laboratory and radiographic tests, outcomes of patients with recurrent melanoma based on method of detection, detection of secondary melanomas, and stage-specific follow-up.

12 Clinical Trial Prognosis of acral melanoma: a series of 281 patients. 2013

Bello, Danielle M / Chou, Joanne F / Panageas, Katherine S / Brady, Mary S / Coit, Daniel G / Carvajal, Richard D / Ariyan, Charlotte E. ·Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. ·Ann Surg Oncol · Pubmed #23838913.

ABSTRACT: BACKGROUND: Acral melanoma (AM) is an unusual malignancy with poor survival. This study defines a cohort of patients, treated at a single institution, and the factors associated with survival and comparison with nonacral cutaneous melanoma (NACM). METHODS: All patients with AM presenting from 1995 to 2010 were identified from a prospectively maintained database. Analysis of clinicopathologic features of AM associated with disease-specific survival (DSS) was performed. A stratified, stage-matched survival analysis compared the outcome of 281 acral to 843 extremity NACM patients. RESULTS: A total of 281 AM patients (170 volar, 111 subungual) were identified. Pathologic stage (p < 0.001), ulceration (p < 0.001), Breslow thickness (p < 0.001), and a positive sentinel lymph node (p < 0.001) were found to be poor prognostic indicators associated with DSS. In stage-matched analysis, AM had a worse DSS compared with NACM (hazard ratio 1.8; 95 % CI 1.2-2.7; p < 0.01). CONCLUSIONS: This study represents the largest, single-institution series describing the characteristics and outcomes of AM. AM tumors exhibit aggressive histopathologic features associated with a poorer survival outcome. AM patients have an inferior survival than extremity NACM when matched for stage, perhaps reflecting inherent alterations in tumor biology. This warrants further investigation into the differences between acral and cutaneous melanoma.

13 Clinical Trial Phase II trial of neoadjuvant temozolomide in resectable melanoma patients. 2010

Shah, G D / Socci, N D / Gold, J S / Wolchok, J D / Carvajal, R D / Panageas, K S / Viale, A / Brady, M S / Coit, D G / Chapman, P B. ·Department of Medicine, Sloan-Kettering Cancer Center, New York, NY, USA. ·Ann Oncol · Pubmed #20080829.

ABSTRACT: BACKGROUND: We treated melanoma patients with temozolomide (TMZ) in the neoadjuvant setting and collected cryopreserved tumor samples before and after treatment. The primary objective was to determine whether the response proportion was higher than previously reported in widely metastatic patients. A secondary objective was to test the feasibility of obtaining adequate tissue before and after treatment for genetic testing. MATERIALS AND METHODS: Chemotherapy-naive melanoma patients who were candidates for surgical resection were eligible. TMZ was administered orally at 75 mg/m(2)/day for 6 weeks of every 8-week cycle. Cycles were repeated until complete response (CR), progression, or stable disease (SD) for two cycles. RESULTS: Of 19 assessable patients, 2 had CRs and 1 had partial response. Four patients had SD; 12 progressed. Tumor O-6-methylguanine-DNA methyltransferase (MGMT) promoter was unmethylated in all nine patients analyzed including from the two CR patients. Pretreatment tumor microarray results were obtained in 16 of 19 patients. CONCLUSIONS: The response proportion to TMZ in the neoadjuvant setting was 16%, not different than in the metastatic setting. Responses were seen even in tumors with a methylated MGMT promoter. Pretreatment cryopreserved tumor adequate for microarray analysis could be obtained in most, but not all, patients. Post-treatment tumor was unavailable in complete responders.

14 Article High neutrophil-to-lymphocyte ratio (NLR) is associated with treatment failure and death in patients who have melanoma treated with PD-1 inhibitor monotherapy. 2019

Bartlett, Edmund K / Flynn, Jessica R / Panageas, Katherine S / Ferraro, Richard A / Sta Cruz, Jessica M / Postow, Michael A / Coit, Daniel G / Ariyan, Charlotte E. ·Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. ·Cancer · Pubmed #31584709.

ABSTRACT: BACKGROUND: An elevated neutrophil-to-lymphocyte ratio (NLR) is associated with poor survival in patients with cancer, including those who receive immunotherapies. The authors sought to investigate NLR as a biomarker of treatment outcomes in patients with melanoma who were treated with PD-1 inhibition. METHODS: Patients undergoing initial treatment with PD-1 inhibitor monotherapy for stage IV melanoma at a single center from 2012 to 2015 were included. Clinical characteristics and the NLR at baseline and before subsequent treatment cycles were collected. The time to treatment failure (TTF) and overall survival (OS) were evaluated using Kaplan-Meier and landmark analyses. RESULTS: Among 224 study patients, 63 (28%) had a baseline NLR ≥5. The baseline NLR was significantly associated with Eastern Cooperative Oncology Group performance status and the number of involved metastatic sites. With a median follow-up of 39 months in survivors, a baseline NLR ≥5 was independently associated with shorter OS (hazard ratio, 2.0; 95% CI, 1.3-2.9) and TTF (hazard ratio, 1.7; 95% CI, 1.2-2.4). An NLR increase ≥30% during the first 2 cycles of treatment was associated with worse OS (median, 47 vs 13.5 months; P < .001) and a trend toward shorter TTF (12.8 vs 5.9 months; P = .05). A combined baseline NLR ≥5 and an NLR increase ≥30% identified a small cohort with markedly shortened OS (median, 5.8 months) and TTF (median, 1.8 months). CONCLUSIONS: Elevated baseline NLR and an increased NLR early during treatment are prognostic for TTF and OS in patients who have melanoma treated with PD-1 inhibitor monotherapy. Combined, these biomarkers can widely risk-stratify patients for treatment failure and survival.

15 Article The Changing Kinetics of Advanced Melanoma. 2019

Coit, Daniel G. ·Memorial Sloan Kettering Cancer Center, New York, New York. ·JAMA Dermatol · Pubmed #31042261.

ABSTRACT: -- No abstract --

16 Article Cutaneous Melanoma, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. 2019

Coit, Daniel G / Thompson, John A / Albertini, Mark R / Barker, Christopher / Carson, William E / Contreras, Carlo / Daniels, Gregory A / DiMaio, Dominick / Fields, Ryan C / Fleming, Martin D / Freeman, Morganna / Galan, Anjela / Gastman, Brian / Guild, Valerie / Johnson, Douglas / Joseph, Richard W / Lange, Julie R / Nath, Sameer / Olszanski, Anthony J / Ott, Patrick / Gupta, Aparna Priyanath / Ross, Merrick I / Salama, April K / Skitzki, Joseph / Sosman, Jeffrey / Swetter, Susan M / Tanabe, Kenneth K / Wuthrick, Evan / McMillian, Nicole R / Engh, Anita M. ·1Memorial Sloan Kettering Cancer Center. · 2Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance. · 3University of Wisconsin Carbone Cancer Center. · 4The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute. · 5University of Alabama at Birmingham Comprehensive Cancer Center. · 6UC San Diego Moores Cancer Center. · 7Fred & Pamela Buffett Cancer Center. · 8Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. · 9St. Jude Children's Research Hospital/The University of Tennessee Health Science Center. · 10City of Hope National Medical Center. · 11Yale Cancer Center/Smilow Cancer Hospital. · 12Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute. · 13Aim at Melanoma. · 14Vanderbilt-Ingram Cancer Center. · 15Mayo Clinic Cancer Center. · 16The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. · 17University of Colorado Cancer Center. · 18Fox Chase Cancer Center. · 19Dana-Farber/Brigham and Women's Cancer Center. · 20Robert H. Lurie Comprehensive Cancer Center of Northwestern University. · 21The University of Texas MD Anderson Cancer Center. · 22Duke Cancer Institute. · 23Roswell Park Comprehensive Cancer Center. · 24Stanford Cancer Institute. · 25Massachusetts General Hospital Cancer Center. · 26Moffitt Cancer Center; and. · 27National Comprehensive Cancer Network. ·J Natl Compr Canc Netw · Pubmed #30959471.

ABSTRACT: The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cutaneous melanoma have been significantly revised over the past few years in response to emerging data on immune checkpoint inhibitor therapies and BRAF-targeted therapy. This article summarizes the data and rationale supporting extensive changes to the recommendations for systemic therapy as adjuvant treatment of resected disease and as treatment of unresectable or distant metastatic disease.

17 Article Adrenal Metastasectomy in the Presence and Absence of Extraadrenal Metastatic Disease. 2019

Russo, Ashley E / Untch, Brian R / Kris, Mark G / Chou, Joanne F / Capanu, Marinela / Coit, Daniel G / Chaft, Jamie E / D'Angelica, Michael I / Brennan, Murray F / Strong, Vivian E. ·Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. · Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY. · Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY. ·Ann Surg · Pubmed #29578911.

ABSTRACT: OBJECTIVE: To determine if there are differences in overall survival (OS) or event-free survival (EFS) in patients with and without concomitant extra-adrenal metastases undergoing adrenal metastasectomy. BACKGROUND: There is growing interest in the use of local therapies in patients with oligometastatic disease. Previously published series have indicated that long-term survival is possible with resection. Adrenalectomy has been used to treat adrenal metastases in select patients. METHODS: Patients who underwent adrenal metastasectomy from 1994 to 2015 were identified from a prospectively maintained institutional database of adrenalectomy patients, excluding adrenalectomies due to tumor extension or for palliation. Sites of disease, treatment history, and survival data were extracted from chart review. RESULTS: One hundred seventy-four patients were included. Tumor histology included 68 nonsmall cell lung cancer, 34 renal cancer, 18 colorectal cancer, 11 melanoma cancer, 10 hepatocellular cancer, 8 sarcoma cancer, and 25 other cancers. The median follow-up among survivors was 5.2 (1-21) years. OS at 3 and 5 years was 50% and 40%, respectively. Patients with (n = 83) and without (n = 91) extra-adrenal metastases did not differ with respect to age, adrenal tumor size, or margin status. Median OS (3.3 years for patients with concomitant extra-adrenal metastases and 3.0 years for patients with isolated adrenal metastases; P = 0.816) and EFS (9.39 vs 9.59 months; P = 0.87) were similar. Factors negatively associated with OS included adrenal tumor size (P < 0.01), renal primary versus other (P < 0.01), and adrenal margin status (P < 0.01). CONCLUSIONS: In selected patients undergoing adrenal metastasectomy, there were no significant differences in OS or EFS between patients with and without concomitant extra-adrenal metastases.

18 Article Peripheral blood clinical laboratory variables associated with outcomes following combination nivolumab and ipilimumab immunotherapy in melanoma. 2018

Rosner, Samuel / Kwong, Erica / Shoushtari, Alexander N / Friedman, Claire F / Betof, Allison S / Brady, Mary Sue / Coit, Daniel G / Callahan, Margaret K / Wolchok, Jedd D / Chapman, Paul B / Panageas, Katherine S / Postow, Michael A. ·Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland. · City University of New York at Hunter College, New York City, New York. · Memorial Sloan Kettering Cancer Center, New York City, New York. · Weill Cornell Medical College, New York City, New York. · Ludwig Center for Cancer Immunotherapy, New York City, New York. ·Cancer Med · Pubmed #29468834.

ABSTRACT: Both the combination of nivolumab + ipilimumab and single-agent anti-PD-1 immunotherapy have demonstrated survival benefit for patients with advanced melanoma. As the combination has a high rate of serious side effects, further analyses in randomized trials of combination versus anti-PD-1 immunotherapy are needed to understand who benefits most from the combination. Clinical laboratory values that were routinely collected in randomized studies may provide information on the relative benefit of combination immunotherapy. To prioritize which clinical laboratory factors to ultimately explore in these randomized studies, we performed a single-center, retrospective analysis of patients with advanced melanoma who received nivolumab + ipilimumab either as part of a clinical trial (n = 122) or commercial use (n = 87). Baseline routine laboratory values were correlated with overall survival (OS) and overall response rate (ORR). Kaplan-Meier estimation and Cox regression were performed. Median OS was 44.4 months, 95% CI (32.9, Not Reached). A total of 110 patients (53%) responded (CR/PR). Significant independent variables for favorable OS included the following: high relative eosinophils, high relative basophils, low absolute monocytes, low LDH, and a low neutrophil-to-lymphocyte ratio. These newly identified factors, along with those previously reported to be associated with anti-PD-1 monotherapy outcomes, should be studied in the randomized trials of nivolumab + ipilimumab versus anti-PD-1 monotherapies to determine whether they help define the patients who benefit most from the combination versus anti-PD-1 alone.

19 Article Transected thin melanoma: Implications for sentinel lymph node staging. 2018

Herbert, Garth / Karakousis, Giorgos C / Bartlett, Edmund K / Zaheer, Salman / Graham, Danielle / Czerniecki, Brian J / Fraker, Douglas L / Ariyan, Charlotte / Coit, Daniel G / Brady, Mary S. ·Department of Surgery, San Antonio Military Medical Center, San Antonio, Texas. · Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. · Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. ·J Surg Oncol · Pubmed #29194673.

ABSTRACT: BACKGROUND AND OBJECTIVES: Indications for sentinel lymph node (SLN) biopsy in patients with thin melanoma (≤1 mm thick) are controversial. We asked whether deep margin (DM) positivity at initial biopsy of thin melanoma is associated with SLN positivity. METHODS: Cases were identified using prospectively maintained databases at two melanoma centers. Patients who had undergone SLN biopsy for melanoma ≤1 mm were included. DM status was assessed for association with SLN metastasis in univariate and multivariate analyses. RESULTS: 1413 cases were identified, but only 1129 with known DM status were included. 39% of patients had a positive DM on original biopsy. DM-positive and DM-negative patients did not differ significantly in primary thickness, ulceration, or mitotic activity. DM-positive and DM-negative patients had similar incidence of SLN metastasis (5.7% vs 3.5%; P = 0.07). Positive DM was not associated with SLN metastasis on univariate analysis (OR 1.69, 95% CI: 0.95-3.00, P = 0.07) or on multivariate analysis adjusted for Breslow depth, Clark level, mitotic rate, and ulceration (OR = 1.59, 95% CI: 0.89-2.85; P = 0.12). CONCLUSIONS: For patients with thin melanoma, a positive DM on initial biopsy is not associated with risk of SLN metastasis, so DM positivity should not be considered an indication for SLN staging in an otherwise low-risk patient.

20 Article Four-month course of adjuvant dabrafenib in patients with surgically resected stage IIIC melanoma characterized by a BRAFV600E/K mutation. 2017

Momtaz, Parisa / Harding, James J / Ariyan, Charlotte / Coit, Daniel G / Merghoub, Taha / Gasmi, Billel / You, Daoqi / Viale, Agnes / Panageas, Katherine S / Samoila, Aliaksandra / Postow, Michael A / Wolchok, Jedd D / Chapman, Paul B. ·Memorial Sloan Kettering Cancer Center, New York, New York, USA. · Weill Cornell Medical College, New York, New York, USA. ·Oncotarget · Pubmed #29285228.

ABSTRACT: Background: We tested the hypothesis that a 4-month course of adjuvant dabrafenib in stage IIIC BRAF-mutated melanoma would improve 2 year RFS from 24% to 51%, and that tumor-derived cell free DNA (cfDNA) in plasma would correlate with and predict recurrence. Methods: Patients with stage IIIC BRAF V600E/K mutated melanoma who were free of disease after surgical resection received 4 months of adjuvant dabrafenib. Patients were evaluated with imaging at baseline, at the end of cycles 2, 4, 6, then every 3 months until disease relapse or 2 years, whichever came first. Serial blood samples were collected for evaluation of cfDNA at the same time. Results: 21/23 patients enrolled were evaluable; 2 patients withdrew consent during the first week of treatment. The 2 year RFS was 28.6% (95% CI 12-48%). The estimated overall survival at 2 years was 78% (95% CI 51-91%). cfDNA detection had a 53% sensitivity in relapsing patients but cfDNA detection did not provide lead-time advantage over CT scanning. Conclusion: A 4-month course of adjuvant dabrafenib did not result in a detectable improvement in 2-year RFS. cfDNA was less sensitive than standard CT imaging and did not provide a lead-time advantage in detecting relapse.

21 Article Eruptive Keratoacanthomas Associated With Pembrolizumab Therapy. 2017

Freites-Martinez, Azael / Kwong, Bernice Y / Rieger, Kerri E / Coit, Daniel G / Colevas, A Dimitrios / Lacouture, Mario E. ·Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Dermatology, Stanford University School of Medicine, Stanford, California. · Department of Pathology and Dermatology, Stanford University School of Medicine, Stanford, California. · Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Head and Neck Surgery, Stanford University Medical Center, Stanford, California. ·JAMA Dermatol · Pubmed #28467522.

ABSTRACT: Importance: To our knowledge, there have been no previous reports of eruptive keratoacanthomas (KAs) in patients receiving pembrolizumab. Objective: To report the cases of 3 consecutive patients with pembrolizumab-induced eruptive KAs and their management. Design, Setting, and Participants: Case report study of 3 patients from 2 centers with pembrolizumab-treated cancer who all developed eruptive KAs. Interventions: All 3 patients had AK treatment with clobetasol ointment and intralesional triamcinolone; 2 patients also underwent open superficial cryosurgery. Results: Three consecutive patients with cancer, 2 men and 1 woman (median age, 83 years; range 77-91 years), experienced pembrolizumab-associated eruptive KAs. All patients presented with a sudden onset of multiple lesions on sun-exposed areas of their extremities after a median of 13 months (range, 4-18 months) of pembrolizumab therapy. On lesional biopsy, a lichenoid infiltrate was observed in the underlying dermis, predominantly composed of CD3+ T cells, scattered CD20+ B cells, and relatively few PD-1+ (programmed cell death 1-positive) T cells, an immunophenotypic pattern also observed in other cases of anti-PD-1-induced lichenoid dermatitis. Patients were treated with clobetasol ointment and intralesional triamcinolone, alone or in combination with open superficial cryosurgery. All KAs resolved in all patients, and no new lesions occurred during close follow-up. Pembrolizumab treatment was continued without disruption in all 3 cases, and all patients had complete responses of their primary cancers. Conclusions and Relevance: Pembrolizumab is used in advanced melanoma, advanced non-small-cell lung cancer, and in head and neck cancer. A variety of dermatologic immune-related adverse events including maculopapular eruption, lichenoid reactions, pruritus, and vitiligo have been described. This case series demonstrates that pembrolizumab therapy may also be associated with eruptive KAs with characteristic dermal inflammation, which improved with corticosteroid treatment (topical and intralesional) alone or in combination with cryosurgery, allowing patients to continue therapy with pembrolizumab.

22 Article Elevated Blood Neutrophil-to-Lymphocyte Ratio: A Readily Available Biomarker Associated with Death due to Disease in High Risk Nonmetastatic Melanoma. 2017

Davis, Jeremy L / Langan, Russell C / Panageas, Katherine S / Zheng, Junting / Postow, Michael A / Brady, Mary S / Ariyan, Charlotte / Coit, Daniel G. ·Department of Surgery; Gastric and Mixed Tumor Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. · Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. · Melanoma and Immunotherapeutics Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. · Weill Cornell Medical College, New York, NY, USA. · Department of Surgery; Gastric and Mixed Tumor Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. coitd@mskcc.org. ·Ann Surg Oncol · Pubmed #28303429.

ABSTRACT: BACKGROUND: Elevated peripheral blood neutrophil-to-lymphocyte ratio (NLR) is associated with poor oncologic outcomes in patients with stage IV melanoma and other solid tumors, but its impact has not been characterized for patients with high-risk, nonmetastatic melanoma. METHODS: Retrospective review of a melanoma database identified patients with high-risk melanoma who underwent operation with curative intent at a single institution. NLR was calculated from blood samples obtained within 2 weeks before operation. Multiple primary melanomas and concurrent hematologic or other metastatic malignancies were excluded. Cumulative incidence of death due to disease was estimated, and Gray's test was used to examine the effect of NLR on melanoma disease-specific death (DOD). Multivariable competing risks regression models assessed associated factors. RESULTS: Data on 1431 patients with high-risk, nonmetastatic melanoma were analyzed. Median follow-up for survivors was 4 years. High NLR (≥3 or as continuous variable) was associated with older age, male sex, thicker primaries, higher mitotic index, and more advanced nodal status. On multivariate analysis, high NLR (≥3 or as a continuous variable), older age, male sex, ulcerated primary, lymphovascular invasion, and positive nodal status were all independently associated with worse DOD. CONCLUSIONS: NLR is a readily available blood test that was independently associated with DOD in patients with high-risk, nonmetastatic melanoma. It is unclear whether high NLR is a passive indicator of poor prognosis or a potential therapeutic target. Further studies to evaluate the prognostic role of NLR to potentially identify those more likely to benefit from adjuvant immunotherapy may prove informative.

23 Article Patterns and Timing of Initial Relapse in Pathologic Stage II Melanoma Patients. 2017

Lee, Ann Y / Droppelmann, Nicolas / Panageas, Katherine S / Zhou, Qin / Ariyan, Charlotte E / Brady, Mary S / Chapman, Paul B / Coit, Daniel G. ·Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. · New York University School of Medicine, New York, NY, USA. · Catholic University of Chile School of Medicine, Santiago, Chile. · Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. · Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. · Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. coitd@mskcc.org. ·Ann Surg Oncol · Pubmed #27804026.

ABSTRACT: PURPOSE: Pathologic stage II melanoma patients have variable outcomes when divided by substage. We hypothesized that an understanding of the patterns of initial relapse by substage will better inform follow-up guidelines. METHODS: We performed a retrospective review of 738 adult patients with pathologic stage II cutaneous melanoma treated at Memorial Sloan Kettering Cancer Center between 1993 and 2013. Clinical records were reviewed to determine time, location, and method of detection of initial relapse. RESULTS: At a median follow-up of 52 months, 219 patients relapsed. Relapses were detected more frequently in higher substages. Initial relapses were most commonly local/in-transit for IIA and IIB and systemic for IIC. Lung and brain were the most frequent sites of systemic relapse. Patient-detection was the most common method of relapse detection (59%) in all substages. The 5-year cumulative incidence for patient-detected relapse was 13.6% for IIA, 18.9% for IIB, and 23.3% for IIC and for image-detected relapse was 3.4, 7.9, and 16.6%, respectively. The 5-year cumulative incidence for physician-detected relapse was less than 10% across all substages and leveled off at 3 years for stage IIA and IIB and 2 years for stage IIC. CONCLUSIONS: Relapses were most frequently patient-detected in all stage II substages, highlighting the importance of patient education and self-examination. The highest yield for routine imaging is in stage IIC patients during the first 4 years. Physician examination is unlikely to detect relapses beyond 3 years for stage IIA and IIB and beyond 2 years for stage IIC patients.

24 Article Prognosis of Mucosal, Uveal, Acral, Nonacral Cutaneous, and Unknown Primary Melanoma From the Time of First Metastasis. 2016

Kuk, Deborah / Shoushtari, Alexander N / Barker, Christopher A / Panageas, Katherine S / Munhoz, Rodrigo R / Momtaz, Parisa / Ariyan, Charlotte E / Brady, Mary Sue / Coit, Daniel G / Bogatch, Kita / Callahan, Margaret K / Wolchok, Jedd D / Carvajal, Richard D / Postow, Michael A. ·Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA. · Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA Weill Cornell Medical College, New York, New York, USA. · Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA. · Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA. · Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA. · Columbia University College of Physicians and Surgeons, New York, New York, USA. · Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA Weill Cornell Medical College, New York, New York, USA postowm@mskcc.org. ·Oncologist · Pubmed #27286787.

ABSTRACT: BACKGROUND: Subtypes of melanoma, such as mucosal, uveal, and acral, are believed to result in worse prognoses than nonacral cutaneous melanoma. After a diagnosis of distant metastatic disease, however, the overall survival of patients with mucosal, uveal, acral, nonacral cutaneous, and unknown primary melanoma has not been directly compared. MATERIALS AND METHODS: We conducted a single-center, retrospective analysis of 3,454 patients with melanoma diagnosed with distant metastases from 2000 to 2013, identified from a prospectively maintained database. We examined melanoma subtype, date of diagnosis of distant metastases, age at diagnosis of metastasis, gender, and site of melanoma metastases. RESULTS: Of the 3,454 patients (237 with mucosal, 286 with uveal, 2,292 with nonacral cutaneous, 105 with acral cutaneous, and 534 with unknown primary melanoma), 2,594 died. The median follow-up was 46.1 months. The median overall survival for those with mucosal, uveal, acral, nonacral cutaneous, and unknown primary melanoma was 9.1, 13.4, 11.4, 11.7, and 10.4 months, respectively. Patients with uveal melanoma, cutaneous melanoma (acral and nonacral), and unknown primary melanoma had similar survival, but patients with mucosal melanoma had worse survival. Patients diagnosed with metastatic melanoma in 2006-2010 and 2011-2013 had better overall survival than patients diagnosed in 2000-2005. In a multivariate model, patients with mucosal melanoma had inferior overall survival compared with patients with the other four subtypes. CONCLUSION: Additional research and advocacy are needed for patients with mucosal melanoma because of their shorter overall survival in the metastatic setting. Despite distinct tumor biology, the survival was similar for those with metastatic uveal melanoma, acral, nonacral cutaneous, and unknown primary melanoma. IMPLICATIONS FOR PRACTICE: Uveal, acral, and mucosal melanoma are assumed to result in a worse prognosis than nonacral cutaneous melanoma or unknown primary melanoma. No studies, however, have been conducted assessing the overall survival of patients with these melanoma subtypes starting at the time of distant metastatic disease. The present study found that patients with uveal, acral, nonacral cutaneous, and unknown primary melanoma have similar overall survival after distant metastases have been diagnosed. These findings provide information for oncologists to reconsider previously held assumptions and appropriately counsel patients. Patients with mucosal melanoma have worse overall survival and are thus a group in need of specific research and advocacy.

25 Article Early-stage non-Spitzoid cutaneous melanoma in patients younger than 22 years of age at diagnosis: long-term follow-up and survival analysis. 2015

Stanelle, Eric J / Busam, Klaus J / Rich, Barrie S / Christison-Lagay, Emily R / Dunkel, Ira J / Marghoob, Ashfaq A / Halpern, Allan / Coit, Daniel G / La Quaglia, Michael P. ·Pediatric Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. · Dermatopathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY. · Department of Pediatrics, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY. · Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY. · Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. · Pediatric Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: laquaglm@mskcc.org. ·J Pediatr Surg · Pubmed #25819019.

ABSTRACT: PURPOSE: We evaluated prognostic factors among young patients with early stage melanoma, with particular attention to survival, recurrence, and development of a second primary melanoma. METHODS: We retrospectively reviewed patients (age <22 years) with pathologically confirmed in-situ and stage 1 non-Spitzoid melanoma treated at our institution from 1980-2010, assessing demographics, clinical presentation, treatment, disease-specific survival, recurrence-free survival, and probability of developing a second primary melanoma. RESULTS: One hundred patients with in-situ melanoma (n=16) or stage 1A (n=48) or 1B (n=36) melanoma were identified. Median age was 19.4 years (range, 11.2-21.9), and median follow-up was 7.6 years (range, 0.1-31.7). Median tumor thickness was 0.76 mm (range, 0.23-2.0). No lesions were ulcerated. All patients underwent wide local excision with negative margins, and 21 had a concomitant negative sentinel lymph node biopsy (SLNB). Sixteen patients developed recurrences, and 8 subsequently died of progressive melanoma. There were 2 non-melanoma-related deaths. Endpoints were 20-year overall survival (77.4%), melanoma-specific mortality (20.1%), recurrence rate (34.0%), and probability of developing a second primary melanoma (24.7%). Greater tumor depth and Clark level were associated with worse prognosis, but age, sex, and tumor mitotic rate were not correlated with recurrence or survival. CONCLUSION: Among younger early-stage melanoma patients, greater lesion depth conferred higher recurrence risk and mortality. Our data did not define the role of sentinel lymph node biopsy in this group.

Next