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Melanoma: HELP
Articles by Alexandra Gangi
Based on 3 articles published since 2010
(Why 3 articles?)

Between 2010 and 2020, Alexandra Gangi wrote the following 3 articles about Melanoma.
+ Citations + Abstracts
1 Review The safety of talimogene laherparepvec for the treatment of advanced melanoma. 2017

Gangi, Alexandra / Zager, Jonathan S. ·a Department of Cutaneous Oncology , Moffitt Cancer Center , Tampa , FL , USA. ·Expert Opin Drug Saf · Pubmed #27989216.

ABSTRACT: INTRODUCTION: Talimogene laherparepvec (T-VEC, IMLYGIC) is an oncolytic herpes virus type I used as intralesional therapy for the treatment of unresectable metastatic melanoma in a cutaneous, subcutaneous, or nodal location. Talimogene laherparepvec selectively replicates within and lyses tumor cells while producing granulocyte macrophage colony-stimulating factor (GM-CSF), which may promote an immune mediated antitumor response. Areas covered: The US Food and Drug Administration approved Talimogene laherparepvec in late 2015 following the completion of phase I, II and III trials that demonstrated safety and efficacy. Current NCCN practice guidelines have added Talimogene laherparepvec as a primary treatment for stage IIIB/C and stage IVM1a melanoma patients with evidence of good durable response rates, and this article sets out to review the use and safety and efficacy of T-VEC Expert opinion: Treatment options for locally advanced and metastatic melanoma are expanding with new developments in immunotherapy and immune checkpoint inhibitors. The ideal treatment of metastatic melanoma continues to be multimodal, combining systemic treatments, intralesional and regional therapies, surgery and radiotherapy to achieve optimal outcomes. Use of talimogene laherparepvec as intrelsional therapy has demonstrated promising effects in select patients with advanced melanoma. Future directions for Talimogene laherparepvec include combination therapies with other systemic immunotherapies such as anti-CTLA-4 antibody and anti-PD-1 drugs.

2 Article Percutaneous hepatic perfusion with melphalan in uveal melanoma: A safe and effective treatment modality in an orphan disease. 2018

Karydis, Ioannis / Gangi, Alexandra / Wheater, Matthew J / Choi, Junsung / Wilson, Iain / Thomas, Kerry / Pearce, Neil / Takhar, Arjun / Gupta, Sanjay / Hardman, Danielle / Sileno, Sean / Stedman, Brian / Zager, Jonathan S / Ottensmeier, Christian. ·Cancer Sciences Academic Unit, University of Southampton, Southampton, United Kingdom. · University Hospital Southampton, Southampton, United Kingdom. · Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida. · Department of Radiology, Moffitt Cancer Center, Tampa, Florida. · Morsani School of Medicine, University of South Florida, Tampa, Florida. ·J Surg Oncol · Pubmed #29284076.

ABSTRACT: BACKGROUND: Metastatic uveal melanoma (UM) carries a poor prognosis; liver is the most frequent and often solitary site of recurrence. Available systemic treatments have not improved outcomes. Melphalan percutaneous hepatic perfusion (M-PHP) allows selective intrahepatic delivery of high dose cytotoxic chemotherapy. METHODS: Retrospective analysis of outcomes data of UM patients receiving M-PHP at two institutions was performed. Tumor response and toxicity were evaluated using RECIST 1.1 and Common Terminology Criteria for Adverse Events (CTCAE) v4.03, respectively. RESULTS: A total of 51 patients received 134 M-PHP procedures (median of 2 M-PHPs). 25 (49%) achieved a partial (N = 22, 43.1%) or complete hepatic response (N = 3, 5.9%). In 17 (33.3%) additional patients, the disease stabilized for at least 3 months, for a hepatic disease control rate of 82.4%. After median follow-up of 367 days, median overall progression free (PFS) and hepatic progression free survival (hPFS) was 8.1 and 9.1 months, respectively and median overall survival was 15.3 months. There were no treatment related fatalities. Non-hematologic grade 3-4 events were seen in 19 (37.5%) patients and were mainly coagulopathic (N = 8) and cardiovascular (N = 9). CONCLUSIONS: M-PHP results in durable intrahepatic disease control and can form the basis for an integrated multimodality treatment approach in appropriately selected UM patients.

3 Article Metastatic melanoma patients' sensitivity to ipilimumab cannot be predicted by tumor characteristics. 2017

Rossfeld, Kara / Hade, Erinn M / Gangi, Alexandra / Perez, Matthew / Kinsey, Emily N / Grabska, Joanna / Ederle, Ashley / Zager, Jonathan / Salama, April K / Olencki, Thomas E / Beasley, Georgia M. ·Division of Surgical Oncology. · Department of Internal Medicine, Division of Medical Oncology, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH. · H. Lee Moffitt Cancer Center, Tampa, FL. · Division of Medical Oncology, Duke University, Durham, NC. · Division of Advanced Oncologic and Gastrointestinal Surgery, Duke University, Durham, NC. ·Int J Surg Oncol (N Y) · Pubmed #29177235.

ABSTRACT: Immune checkpoint inhibitors have dramatically changed the prognosis for patients with metastatic melanoma. However, not all patients respond to therapy and toxicities can be severe leaving need for reliable clinical predictive markers. Methods: We examined primary tumor characteristics including ulceration, BRAF mutation status, and Breslow depth in patients who subsequently developed stage IV disease and were treated with ipilimumab at 3 institutions. Patients in this study were not treated on clinical trials. To investigate the relationship between patient characteristics at the time of diagnosis and survival following melanoma diagnosis we utilized Cox proportional hazards models, accounting for delayed entry into the study cohort. Cox models estimate the age and institution adjusted hazard ratios for risk of death. Results: Of patients (n=385) treated with ipilimumab for stage IV melanoma, 302 met inclusion criteria. The complete response to ipilimumab was 5%, partial response was 13%, 18% had stable disease, 62% had progressive disease, and 5 unknown. The median overall survival rate was 2.03 years [95% confidence interval (CI): 0.13, 3.05]. Primary tumor Breslow depth, lymphovascular invasion, BRAF status, and ulceration did not predict sensitivity to ipilimumab. In this study patient cohort, BRAF mutation (adjusted hazard ratio: 1.43, 95% CI: 0.98, 2.07) and presence of ulceration (adjusted hazard ratio: 1.47, 95% CI: 0.95, 2.26) contributed to an increased risk of death. Conclusions: The presence of ulceration did not correlate with sensitivity to ipilimumab. Ulceration of the primary tumor and a BRAF mutation were moderately associated with worse survival in patients with metastatic melanoma treated with ipilimumab.