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Melanoma: HELP
Articles by Pietro Quaglino
Based on 76 articles published since 2010
(Why 76 articles?)
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Between 2010 and 2020, P. Quaglino wrote the following 76 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Review Immune-checkpoint inhibitors for the treatment of metastatic melanoma: a model of cancer immunotherapy. 2019

Queirolo, Paola / Boutros, Andrea / Tanda, Enrica / Spagnolo, Francesco / Quaglino, Pietro. ·IRCCS Ospedale Policlinico San Martino, Skin Cancer Unit, Genoa, Italy. · IRCCS Ospedale Policlinico San Martino, Skin Cancer Unit, Genoa, Italy. Electronic address: francesco.spagnolo85@gmail.com. · Dermatologic Clinic, Department of Medical Sciences, University of Turin Medical School, Italy. ·Semin Cancer Biol · Pubmed #31430555.

ABSTRACT: Melanoma has always been described as an immunogenic tumor. Despite that, until 2011 the standard of care in metastatic melanoma was chemotherapy, with low response rates and no clear impact on overall survival. Melanoma was the first cancer type to drive the use of immune-checkpoint inhibitors into clinical practice, which revolutionized the therapeutic paradigm not only in melanoma, but also in an increasing number of tumors. In this review, the preclinical bases and the main clinical studies that led to the approval of immune-checkpoint inhibitors in advanced melanoma will be described with insights on novel combinations of treatments and on prognostic and predictive biomarkers.

2 Review New paradigm for stage III melanoma: from surgery to adjuvant treatment. 2019

Ascierto, Paolo Antonio / Borgognoni, Lorenzo / Botti, Gerardo / Guida, Michele / Marchetti, Paolo / Mocellin, Simone / Muto, Paolo / Palmieri, Giuseppe / Patuzzo, Roberto / Quaglino, Pietro / Stanganelli, Ignazio / Caracò, Corrado. ·Unit Melanoma, Cancer Immunotherapy and Innovative Therapies, Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Naples, Italy. paolo.ascierto@gmail.com. · Ospedale Santa Maria Annunziata and University of Florence, Florence, Italy. · Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Naples, Italy. · Unit Melanoma and Rare Tumors, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy. · Oncologia Medica B Policlinico Umberto I di Roma, Rome, Italy. · Surgical Oncology Unit, IOV-IRCCS of Padova and Dept. Surgery Oncology Gastroenterology, University of Padova, Padua, Italy. · Unit of Cancer Genetics, ICB-CNR, Sassari, Italy. · Research Director CNR, Italian Melanoma Intergroup (IMI), Unit of Cancer Genetics, Head Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Sassari, Italy. · IRCCS Fondazione Istituto Nazionale dei Tumori di Milano, Milan, Italy. · Dermatologic Clinic, Department of Medical Sciences, University of Turin Medical School, Turin, Italy. · Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, FC, Italy. · University of Parma, Parma, Italy. ·J Transl Med · Pubmed #31412885.

ABSTRACT: BACKGROUND: Recently the 8th version of the American Joint Committee on Cancer (AJCC) classification has been introduced, and has attempted to define a more accurate and precise definition of prognosis in line with the major progresses in understanding the biology and pathogenesis of melanoma. This new staging system introduces major changes in the stage III staging system. Indeed, surgical practice is changing in stage III patients, since, according to recent evidence, there is no survival benefit in radical lymph node dissection following a positive sentinel lymph node dissection. Therefore, some patients currently staged IIIB-C after dissection could be downgraded to IIIA (as in the case of patients with metastatic non-sentinel lymph nodes) since many completion lymph node dissections will no longer be performed. Moreover, new and effective targeted and immune strategies are being introduced in the pharmacological armamentarium in the adjuvant setting, showing major efficacy. CONCLUSIONS: This article provides the authors' personal view on the above-mentioned topics.

3 Review Malignant Melanoma in People Living with HIV/AIDS: Can We Know More, Can We Do Better? 2019

Trunfio, Mattia / Ribero, Simone / Bonora, Stefano / Di Perri, Giovanni / Quaglino, Pietro / Andrea, Calcagno. ·Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, Torino, Italy. · Dermatologic Clinic, Department of Medical Sciences, University of Torino, Torino, Italy. ·AIDS Rev · Pubmed #31332396.

ABSTRACT: Thanks to the advancement in understanding of molecular mechanisms driving immune surveillance, we have now approached a revolutionary era for the treatment of malignant melanoma (MM). Meanwhile, people living with HIV/AIDS (PLWHA) are aging and non-AIDS-related cancers have become a leading cause of death. Both HIV infection and melanoma share common immune-pathological pathways: immune checkpoints are being targeted for melanoma immunotherapy and investigated as a "shock and kill" strategy for latency reversion among HIV-positive individuals. Nevertheless, a substantial lack of information exists on epidemiology, clinical features, and management of MM in HIV, due to compartmentalized approaches and poor awareness about the problem. In this narrative review, we aimed at analyzing available data regarding MM in PLWHA to point out key knowledge gaps and future opportunities from an integrated dermatology, oncology, and infectious diseases standpoint. To date, a strong association between HIV infection and MM risk still needs to be effectively demonstrated; nevertheless, once this cancer has developed in HIV-positive people, it shows more aggressive course, worse prognosis, and seemingly peculiar clinical and histological features. Despite these challenges, a syndemic framework should lead us toward a tailored and multidisciplinary approach not to miss valuable opportunities from the worst situations including the enrolment of HIV-positive patients in the ongoing trials with immune checkpoint inhibitors.

4 Review Effect of Age on Melanoma Risk, Prognosis and Treatment Response. 2018

Ribero, Simone / Stucci, Luigia Stefania / Marra, Elena / Marconcini, Riccardo / Spagnolo, Francesco / Orgiano, Laura / Picasso, Virginia / Queirolo, Paola / Palmieri, Guiseppe / Quaglino, Pietro / Bataille, Veronique. ·Department of Medical Sciences, Section of Dermatology, University of Turin, IT-10126 Turin, Italy. simone.ribero@unito.it. ·Acta Derm Venereol · Pubmed #29648671.

ABSTRACT: As for all types of cancer, the incidence of melanoma increases with age. However, naevus counts (the principal risk factor for melanoma) decrease with age; hence the relationship between ageing and melanoma is complex. Subjects who maintain a high naevus count after the age of 50 years are more likely to be affected by melanoma, as their lesions do not senesce. Longer telomere length, which is strongly related to age, is linked to high naevus counts/melanoma risk; thus melanoma biology is influenced by factors that slow down ageing. Age is also an important prognostic factor in melanoma. Increasing age leads to worse survival in stages I, II and III. Sentinel lymph node (SLN) status, which is a strong predictor of melanoma survival, is also affected by age, as SLN positivity decreases with age. However, the prognostic value of SLN on survival increases with age, so, again, these relationships are complex. In patients with stage IV melanoma, age impacts on survival because it affects responses to treatment. This review examines the effects of age on melanoma risk, prognostic factors and responses to treatment.

5 Review Updated standard operating procedures for electrochemotherapy of cutaneous tumours and skin metastases. 2018

Gehl, Julie / Sersa, Gregor / Matthiessen, Louise Wichmann / Muir, Tobian / Soden, Declan / Occhini, Antonio / Quaglino, Pietro / Curatolo, Pietro / Campana, Luca G / Kunte, Christian / Clover, A James P / Bertino, Giulia / Farricha, Victor / Odili, Joy / Dahlstrom, Karin / Benazzo, Marco / Mir, Lluis M. ·a Center for Experimental Drug and Gene Electrotransfer (C*EDGE), Department of Clinical Oncology and Palliative Care , Zealand University Hospital , Roskilde , Denmark. · b Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark. · c Department of Oncology Herlev and Gentofte Hospital , University of Copenhagen , Herlev , Denmark. · d Department of Experimental Oncology , Institute of Oncology Ljubljana , Ljubljana , Slovenia. · e South Tees NHS Foundation Trust , James Cook University Hospital , Middlesbrough , UK. · f Cork Cancer Research Centre , Western Gateway Building University College Cork , Cork , Ireland. · g Department of Otolaryngology Head and Neck Surgery , University of Pavia - IRCCS Policlinico San Matteo Foundation , Pavia , Italy. · h Department of Medical Sciences , Dermatologic Clinic, University of Turin , Turin , Italy. · i Department of Dermatology and Plastic Surgery , La Sapienza University , Roma , Italy. · j Department of Surgery Oncology and Gastroenterology (DISCOG) , University of Padova , Padova , Italy. · k Surgical Oncology Unit , Veneto Institute of Oncology IRCCS , Padova , Italy. · l Department of Dermatologic Surgery and Dermatology , Artemed Fachklinik München , Munich , Germany. · m Department of Dermatology and Allergology , Ludwig-Maximillian University , Munich , Germany. · n Department of Plastic Surgery , Cork University Hospital , Cork , Ireland. · o Melanoma and Sarcoma Unit Department of Surgery , Portuguese Institute of Oncology, Rua Professor Lima Basto, Faculty of Medicine of Lisbon , Lisbon , Portugal. · p Department of Plastic Surgery , St. George's University Hospitals NHS Foundation Trust , London , UK. · q Department of Plastic Surgery , Herlev and Gentofte Hospital, University of Copenhagen , Copenhagen , Denmark. · r Vectorology and Anticancer Therapies , UMR 8203, CNRS, Univ. Paris-Sud, Gustave Roussy, Université Paris-Saclay , Villejuif , France. ·Acta Oncol · Pubmed #29577784.

ABSTRACT: Electrochemotherapy is now in routine clinical use to treat cutaneous metastases of any histology, and is listed in national and international guidelines for cutaneous metastases and primary skin cancer. Electrochemotherapy is used by dermatologists, surgeons, and oncologists, and for different degrees and manifestations of metastases to skin and primary skin tumours not amenable to surgery. This treatment utilises electric pulses to permeabilize cell membranes in tumours, thus allowing a dramatic increase of the cytotoxicity of anti-cancer agents. Response rates, often after only one treatment, are very high across all tumour types. The most frequent indications are cutaneous metastases from malignant melanoma and breast cancer. In 2006, standard operating procedures (SOPs) were written for this novel technology, greatly facilitating introduction and dissemination of the therapy. Since then considerable experience has been obtained treating a wider range of tumour histologies and increasing size of tumours which was not originally thought possible. A pan-European expert panel drawn from a range of disciplines from dermatology, general surgery, head and neck surgery, plastic surgery, and oncology met to form a consensus opinion to update the SOPs based on the experience obtained. This paper contains these updated recommendations for indications for electrochemotherapy, pre-treatment information and evaluation, treatment choices, as well as follow-up.

6 Review Treatment of metastatic melanoma: a multidisciplinary approach. 2017

Fava, Paolo / Astrua, Chiara / Sanlorenzo, Martina / Ribero, Simone / Brizio, Matteo / Filippi, Andrea R / Marra, Elena / Picciotto, Franco / Sangiolo, Dario / Carnevale-Schianca, Fabrizio / Aglietta, Massimo / Sandrucci, Sergio / Ricardi, Umberto / Caliendo, Virginia / Quaglino, Pietro / Fierro, Maria T. ·Clinic of Dermatology, Department of Medical Sciences, School of Medicine, University of Turin, Turin, Italy. · Department of Dermatology, Mt. Zion Cancer Research Center, University of California, San Francisco, CA, USA. · Department of Oncology, University of Turin, Turin, Italy. · Radiation Oncology Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy. · Section of Surgical Dermatology, AOU Città della Salute e della Scienza, Turin, Italy. · Medical Oncology Unit, Candiolo Cancer Institute FPO-IRCCS, Candiolo, Turin, Italy. · Sarcoma Unit, Department of Surgery, University of Turin, Turin, Italy. · Clinic of Dermatology, Department of Medical Sciences, School of Medicine, University of Turin, Turin, Italy - pietro.quaglino@unito.it. ·G Ital Dermatol Venereol · Pubmed #28290625.

ABSTRACT: The prognosis of stage IV metastatic melanoma is poor. An overall 1-year survival of 25.5% and a median survival of 6.2 months were reported without any significant improvement during the last 30 years before the introduction of new drugs (immune checkpoint inhibitors and targeted therapies) which completely modified the therapeutic approach and induced an overwhelming improvement on the survival rates of these patients. This review will analyze the therapeutic tools available for the treatment of patients with metastatic melanoma, including adjuvant interferon and locoregional therapies (surgery, radiotherapy and electrochemotherapy) and will mainly focus on the presentation of results obtained by the new treatments (checkpoint inhibitors and targeted therapies).

7 Review Role of interferon in melanoma: old hopes and new perspectives. 2017

Sanlorenzo, Martina / Vujic, Igor / Carnevale-Schianca, Fabrizio / Quaglino, Pietro / Gammaitoni, Loretta / Fierro, Maria Teresa / Aglietta, Massimo / Sangiolo, Dario. ·a Department of Oncology , University of Torino , Candiolo , Torino , Italy. · b Department of Medical Sciences, Section of Dermatology , University of Turin , Torino , Italy. · c Division of Medical Oncology, Experimental Cell Therapy , Candiolo Cancer Institute , Candiolo , Torino , Italy. · d School of Medicine , Sigmund Freud University , Vienna , Austria. · e Department of Dermatology , The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna , Vienna , Austria. ·Expert Opin Biol Ther · Pubmed #28274138.

ABSTRACT: INTRODUCTION: Interferons (IFNs) play a key role in modulating anti-microbial and antitumor immune responses. In oncology, past attempts to exploit IFNs therapeutically did not fulfill expectations, and had only modest clinical results, mostly limited to adjuvant melanoma treatment. The recent successes of immunotherapy in oncology have brought new attention to the potential of immune-modulatory agents like the IFNs. Areas covered: The authors review the biological effects of IFN on melanoma and immune cells. Then, the authors summarize the clinical results of adjuvant and therapeutic IFN in melanoma, giving focus to possible prognostic factors and new on-going clinical trials. Expert opinion: IFNs offer intriguing opportunities for synergism between conventional treatments and recently introduced molecular-targeted and immunotherapy approaches. However, the full comprehension of all IFN effects and their multiple biologic links is challenging. A strong commitment toward parallel translational research is needed to facilitate the interpretation of IFN's expected and unexpected effects, guiding the rational design of informative clinical studies.

8 Review Prognostic role of histological regression in cutaneous melanoma. 2017

Ribero, Simone / Osella-Abate, Simona / Dika, Emi / Sportoletti Baduel, Eugenio / Marra, Elena / Picciotto, Franco / Caliendo, Virginia / Fierro, Maria T / Quaglino, Pietro. ·Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy - simone.ribero@unito.it. · Section of Dermatologic Surgery, Department of Oncology, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy - simone.ribero@unito.it. · Section of Surgical Pathology, Department of Medical Sciences, University of Turin, Turin, Italy. · Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy. · Section of Dermatologic Surgery, Department of Oncology, University Hospital "Città della Salute e della Scienza di Torino", Turin, Italy. · Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy. ·G Ital Dermatol Venereol · Pubmed #27845512.

ABSTRACT: Histological regression in primary cutaneous melanoma occurs in 10-35% of cases. Although there is a large body of literature on histological regression and prognosis in melanoma patients, not clear data concerning this feature has been reported. In the current review, a comprehensive overview of the main aspects of regression will be provided. The clinical utility of regression as a prognostic factor has been challenged recently. Nowadays evidences reported that this feature is protective on SLN metastases. Despite its association with poor prognostic factors, it maintained a favourable prognostic role in many different survival studies.

9 Review Sentinel lymph node biopsy in cutaneous melanoma. 2017

Ribero, Simone / Sportoletti Baduel, Eugenio / Osella-Abate, Simona / Dika, Emi / Quaglino, Pietro / Picciotto, Franco / Macripò, Giuseppe / Bataille, Veronique. ·Section of Dermatologic Surgery, Department of Oncology, Città della Salute e della Scienza di Torino Hospital, Turin, Italy - Simone.ribero@unito.it. · Section of Dermatology, Department of Medical Sciences, University of Turin, Turin Italy - Simone.ribero@unito.it. · Department of Twins Research and Genetic Epidemiology, King's College London, London, UK - Simone.ribero@unito.it. · Section of Dermatologic Surgery, Department of Oncology, Città della Salute e della Scienza di Torino Hospital, Turin, Italy. · Section of Surgical Pathology, Department of Medical Sciences, University of Turin, Turin, Italy. · Dermatology Department, University of Bologna, Bologna, Italy. · Section of Dermatology, Department of Medical Sciences, University of Turin, Turin Italy. · Department of Twins Research and Genetic Epidemiology, King's College London, London, UK. ·G Ital Dermatol Venereol · Pubmed #27248147.

ABSTRACT: The management of melanoma is constantly evolving. New therapies and surgical advances have changed the landscape over the last years. Since being introduced by Dr Donald Morton, the role of sentinel lymph node has been debated. In many melanoma centers, sentinel node biopsy is not a standard of care for melanoma above 1 mm in thickness. The results of the MSLT-II Trial are not available for a while and in the meantime, this procedure is offered as a prognostic indicator as it has been shown to be very useful for assessing risk of relapse. The biology of lymph node spread in melanoma is a complex field and there are many factors which influence it such as age, melanoma body site, thickness but other factors such as regression, ulceration and gender need further evaluation. In this review, we address the clinical value of sentinel lymph node biopsy and how its indication has changed over the years especially recently with the setup of many adjuvant trials which are offered to stage 3 melanomas.

10 Review Radiotherapy and immune checkpoints inhibitors for advanced melanoma. 2016

Filippi, Andrea Riccardo / Fava, Paolo / Badellino, Serena / Astrua, Chiara / Ricardi, Umberto / Quaglino, Pietro. ·Department of Oncology, Radiation Oncology, University of Torino, Italy. Electronic address: andreariccardo.filippi@unito.it. · Department of Medical Sciences, Dermatology/Oncology, University of Torino, Italy. · Department of Oncology, Radiation Oncology, University of Torino, Italy. ·Radiother Oncol · Pubmed #27345592.

ABSTRACT: INTRODUCTION: The therapeutic landscape of metastatic melanoma drastically changed after the introduction of targeted therapies and immunotherapy, in particular immune checkpoints inhibitors (ICI). In recent years, positive effects on the immune system associated to radiotherapy (RT) were discovered, and radiation has been tested in combination with ICI in both pre-clinical and clinical studies (many of them still ongoing). We here summarize the rationale and the preliminary clinical results of this approach. MATERIALS AND METHODS: In the first part of this review article, redacted with narrative non-systematic methodology, we describe the clinical results of immune checkpoints blockade in melanoma as well as the biological basis for the combination of ICI with RT; in the second part, we systematically review scientific publications reporting on the clinical results of the combination of ICI and RT for advanced melanoma. RESULTS: The biological and mechanistic rationale behind the combination of ICI and radiation is well supported by several preclinical findings. Retrospective observational series and few prospective trials support the potential synergistic effect between radiation and ICI for metastatic melanoma. CONCLUSION: RT may potentiate anti-melanoma activity of ICI by enhancing response on both target and non-target lesions. Several prospective trials are ongoing with the aim of further exploring this combination in the clinical setting, hopefully confirming initial observations and opening a new therapeutic window for advanced melanoma patients.

11 Review Synergy of molecular targeted approaches and immunotherapy in melanoma: preclinical basis and clinical perspectives. 2015

Sanlorenzo, Martina / Vujic, Igor / Moy, Adrian / Quaglino, Pietro / Fierro, Maria Teresa / Gammaitoni, Loretta / Carnevale-Schianca, Fabrizio / Aglietta, Massimo / Sangiolo, Dario. ·a 1 University of Turin, Department of Medical Sciences, Section of Dermatology , Via Cherasco 23, Torino, Italy. · b 2 University of California San Francisco, Mt. Zion Cancer Research Center , 2340 Sutter Street N461, San Francisco, CA, USA. · c 3 Candiolo Cancer Institute FPO- IRCCS, Division and Laboratory of Medical Oncology , Candiolo, Torino, Italy. · d 4 University of Torino, Department of Oncology , Torino, Italy +390119933503 ; +390119933522 ; dario.sangiolo@ircc.it. ·Expert Opin Biol Ther · Pubmed #26206099.

ABSTRACT: INTRODUCTION: Targeted therapy and immunotherapies are the novel pharmacologic treatment strategies for metastatic melanoma. BRAF and MEK inhibitors effectively block the hyperactivation of the MAPK pathway in BRAF mutant melanomas and also have several other effects on melanoma cells and on the immune response. The aim of this work is to discuss the rationale, evidence and perspectives of approaches combining target and immunotherapy against melanoma. AREAS COVERED: We first review the effects of BRAF and MEK inhibitors on melanoma cells and on the different components of the immune system. Afterwards, we summarize the results of the preclinical and clinical studies that have combined targeted therapy and immunotherapy for the treatment of melanoma. EXPERT OPINION: Clinical applications of immunotherapy strategies have recently changed the therapeutic mainstay for metastatic melanoma. Biologic and initial preclinical data support their integration with innovative molecular targeted therapies, opening enormous perspectives for researchers in the effort of finding a definitive cure. Main open challenges are the definition of reliable research models, assessment of effective schedules, safety issues and designing of personalized approaches.

12 Review The risk of melanoma in airline pilots and cabin crew: a meta-analysis. 2015

Sanlorenzo, Martina / Wehner, Mackenzie R / Linos, Eleni / Kornak, John / Kainz, Wolfgang / Posch, Christian / Vujic, Igor / Johnston, Katia / Gho, Deborah / Monico, Gabriela / McGrath, James T / Osella-Abate, Simona / Quaglino, Pietro / Cleaver, James E / Ortiz-Urda, Susana. ·Mount Zion Cancer Research Center, Department of Dermatology, University of California, San Francisco2Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy. · Mount Zion Cancer Research Center, Department of Dermatology, University of California, San Francisco3School of Medicine, Stanford University, Stanford, California. · Mount Zion Cancer Research Center, Department of Dermatology, University of California, San Francisco. · Department of Epidemiology and Biostatistics, University of California, San Francisco. · Center for Devices and Radiological Health, Division of Physics, US Food and Drug Administration, Silver Spring, Maryland. · Mount Zion Cancer Research Center, Department of Dermatology, University of California, San Francisco6Department of Dermatology,The Rudolfstiftung Hospital, Vienna, Austria. · Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy. ·JAMA Dermatol · Pubmed #25188246.

ABSTRACT: IMPORTANCE: Airline pilots and cabin crew are occupationally exposed to higher levels of cosmic and UV radiation than the general population, but their risk of developing melanoma is not yet established. OBJECTIVE: To assess the risk of melanoma in pilots and airline crew. DATA SOURCES: PubMed (1966 to October 30, 2013), Web of Science (1898 to January 27, 2014), and Scopus (1823 to January 27, 2014). STUDY SELECTION: All studies were included that reported a standardized incidence ratio (SIR), standardized mortality ratio (SMR), or data on expected and observed cases of melanoma or death caused by melanoma that could be used to calculate an SIR or SMR in any flight-based occupation. DATA EXTRACTION AND SYNTHESIS: Primary random-effect meta-analyses were used to summarize SIR and SMR for melanoma in any flight-based occupation. Heterogeneity was assessed using the χ2 test and I2 statistic. To assess the potential bias of small studies, we used funnel plots, the Begg rank correlation test, and the Egger weighted linear regression test. MAIN OUTCOMES AND MEASURES: Summary SIR and SMR of melanoma in pilots and cabin crew. RESULTS: Of the 3527 citations retrieved, 19 studies were included, with more than 266 431 participants. The overall summary SIR of participants in any flight-based occupation was 2.21 (95% CI, 1.76-2.77; P < .001; 14 records). The summary SIR for pilots was 2.22 (95% CI, 1.67-2.93; P = .001; 12 records). The summary SIR for cabin crew was 2.09 (95% CI, 1.67-2.62; P = .45; 2 records). The overall summary SMR of participants in any flight-based occupation was 1.42 (95% CI, 0.89-2.26; P = .002; 6 records). The summary SMR for pilots was 1.83 (95% CI, 1.27-2.63, P = .33; 4 records). The summary SMR for cabin crew was 0.90 (95% CI, 0.80-1.01; P = .97; 2 records). CONCLUSIONS AND RELEVANCE: Pilots and cabin crew have approximately twice the incidence of melanoma compared with the general population. Further research on mechanisms and optimal occupational protection is needed.

13 Review Melanoma immunotherapy. 2014

Sanlorenzo, Martina / Vujic, Igor / Posch, Christian / Dajee, Akshay / Yen, Adam / Kim, Sarasa / Ashworth, Michelle / Rosenblum, Michael D / Algazi, Alain / Osella-Abate, Simona / Quaglino, Pietro / Daud, Adil / Ortiz-Urda, Susanna. ·University of California San Francisco; San Francisco, CA USA; Department of Medical Sciences; Section of Dermatology; University of Turin; Turin, Italy. · University of California San Francisco; San Francisco, CA USA; The Rudolfstiftung Hospital; Vienna, Austria. · University of California San Francisco; San Francisco, CA USA. · Department of Medical Sciences; Section of Dermatology; University of Turin; Turin, Italy. ·Cancer Biol Ther · Pubmed #24651672.

ABSTRACT: Immunotherapy is a cornerstone in the treatment of melanoma, and is intended to modulate the host immunity against the tumor. Immunotherapy can be used in an adjuvant setting, after complete surgical excision in patients with a high risk of disease relapse and as a treatment in advanced (unresectable or metastatic) stages. Development of novel therapeutic approaches and the optimization of existing therapies hold a great promise in the field of melanoma therapy research. Different clinical trials are ongoing, and immunotherapy is showing the ability to confirm durable clinical benefits in selected groups of melanoma patients. The aim of this review is to summarize different types of immunotherapy agents, as well as to discuss different strategies, complementary regimens, and possible biomarkers of response to the treatment.

14 Review Clinico-pathologic features of primary melanoma and sentinel lymph node predictive for non-sentinel lymph node involvement and overall survival in melanoma patients: a single centre observational cohort study. 2011

Quaglino, P / Ribero, S / Osella-Abate, S / Macrì, L / Grassi, M / Caliendo, V / Asioli, S / Sapino, A / Macripò, G / Savoia, P / Bernengo, M G. ·Department of Biomedical Sciences and Human Oncology, Section of Dermatology, 1st Dermatologic Division, University of Turin, Italy. pietro.quaglino@unito.it ·Surg Oncol · Pubmed #21145730.

ABSTRACT: OBJECTIVE: Completion Lymph Node Dissection (CLND) is the current standard of practice for patients with a positive Sentinel Lymph Node Biopsy (SLNB). Significant morbidity is associated to CLND, so we tried to evaluate which prognostic variables could predict NSLN invasion in SLN-positive patients and their impact on the overall survival (OS). METHODS: A retrospective chart review of 603 patients that had undergone SLNB for melanoma between 2000 and 2009 at our department was done. 100 SLN were positive at the histopathological analysis of SLN. Demographic variables, primary melanoma, SLN pathologic features and results of CLND were analysed. Multivariate logistic regression and OS analyses were carried out to test the prognostic relevance of clinico-pathologic variables on CLND results and disease course. RESULTS: Breslow thickness, ulceration and micro/macrometastatic pattern of SLN invasion carried a significantly independent higher likelihood of NSLN involvement; Starz classification did not maintain a statistical significance in multivariate analysis. Only one patient (4.3%) without adverse prognostic factors showed NSLN involvement, which was found in 33.3% of patients with one and 55.9% with two or more adverse parameters (p = 0.0001). OS analyses confirmed the prognostic significance of these factors. CONCLUSION: Waiting for the results of Multicenter Selective Lymphadenectomy Trial II, our study suggests a clinically useful and easily applicable means of identifying patients with an unfavourable disease course. The presence of one or more adverse factors identifies patients in whom CLND is mandatory to include thereafter in a more strict follow-up program. Moreover, the finding of no adverse prognostic indicators associated to the presence of significant co-morbidities and/or elderly age, could be useful in identifying patients not to treat by CLND.

15 Clinical Trial Electrochemotherapy in the treatment of metastatic malignant melanoma: a prospective cohort study by InspECT. 2017

Kunte, C / Letulé, V / Gehl, J / Dahlstroem, K / Curatolo, P / Rotunno, R / Muir, T / Occhini, A / Bertino, G / Powell, B / Saxinger, W / Lechner, G / Liew, S-H / Pritchard-Jones, R / Rutkowski, P / Zdzienicki, M / Mowatt, D / Sykes, A J / Orlando, A / Mitsala, G / Rossi, C R / Campana, L / Brizio, M / de Terlizzi, F / Quaglino, P / Odili, J / Anonymous3590894. ·Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany. · Center for Experimental Drug and Gene Electrotransfer, Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark. · Department of Plastic Surgery, Copenhagen University Hospital Herlev, Denmark. · Department of Dermatology and Plastic Surgery, Dermatologic Clinic, University of Rome 'La Sapienza', Rome, Italy. · Department of Reconstructive Plastic Surgery, James Cook University Hospital, Middlesbrough, U.K. · Department of Otolaryngology Head & Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. · Department of Plastic Surgery, St George's Hospital, London, U.K. · Department of Dermatology, Klinikum Wels-Grieskirchen, Wels, Austria. · Department of Plastic Surgery, Whiston Hospital, Prescot, Merseyside, U.K. · Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland. · Department of Plastic Surgery. · Department of Clinical Oncology, Christie Hospital, NHS Foundation Trust, Manchester, U.K. · Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, U.K. · Veneto Institute of Oncology IOV-IRCCS, Padova, Italy. · Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy. · Department of Medical Sciences, Dermatologic Clinic, University of Torino, Torino, Italy. · Scientific and Medical Department, IGEA S.p.A., Carpi, Italy. ·Br J Dermatol · Pubmed #28118487.

ABSTRACT: BACKGROUND: (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. OBJECTIVES: To investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors that affect (beneficially or adversely) the outcome. METHODS: Thirteen cancer centres in the International Network for Sharing Practices on Electrochemotherapy consecutively and prospectively uploaded data to a common database. ECT consisted of intratumoral or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia. RESULTS: In total, 151 patients with metastatic melanoma were identified from the database, 114 of whom had follow-up data of 60 days or more. Eighty-four of these patients (74%) experienced an overall response (OR = complete response + partial response). Overall, 394 lesions were treated, of which 306 (78%) showed OR, with 229 showing complete response (58%). In multivariate analysis, factors positively associated with overall response were coverage of deep margins, absence of visceral metastases, presence of lymphoedema and treatment of nonirradiated areas. Factors significantly associated with complete response to ECT treatment were coverage of deep margins, previous irradiation of the treated area and tumour size (< 3 cm). One-year overall survival in this cohort of patients was 67% (95% confidence interval 57-77%), while melanoma-specific survival was 74% (95% confidence interval 64-84%). No serious adverse events were reported, and the treatment was in general very well tolerated. CONCLUSIONS: ECT is a highly effective local treatment for melanoma metastases in the skin, with no severe adverse effects noted in this study. In the presence of certain clinical factors, ECT may be considered for local tumour control as an alternative to established local treatments, or as an adjunct to systemic treatments.

16 Clinical Trial Ipilimumab retreatment in patients with pretreated advanced melanoma: the expanded access programme in Italy. 2014

Chiarion-Sileni, V / Pigozzo, J / Ascierto, P A / Simeone, E / Maio, M / Calabrò, L / Marchetti, P / De Galitiis, F / Testori, A / Ferrucci, P F / Queirolo, P / Spagnolo, F / Quaglino, P / Carnevale Schianca, F / Mandalà, M / Di Guardo, L / Del Vecchio, M. ·Melanoma Cancer Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy. · Melanoma, Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori Fondazione 'G Pascale', Via Cappella dei Cangiani, 1, 80131 Naples, Italy. · Medical Oncology and Immunotherapy Unit, University Hospital of Siena, Istituto Toscano Tumori, Strada delle Scotte, 14, 53100 Siena, Italy. · 1] Medical Oncology, Dermopathic Institute of the Immaculate IDI-IRCCS, Via dei Monti di Creta, 104, 00167 Rome, Italy [2] Medical Oncology, Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035-39, 00189 Rome, Italy. · Medical Oncology, Dermopathic Institute of the Immaculate IDI-IRCCS, Via dei Monti di Creta, 104, 00167 Rome, Italy. · Divisione Melanoma, Istituto Europeo di Oncologia, Via Ripamonti, 435, 20141 Milan, Italy. · Oncology of Melanoma Unit, Istituto Europeo di Oncologia, Via Ripamonti, 435, 20141 Milan, Italy. · Department of Medical Oncology A, San Martino Hospital, National Institute for Cancer Research, L.go R. Benzi, 10, 16132 Genoa, Italy. · Dermatologic Clinic, Department of Medical Sciences, University of Torino, San Giovanni Battista di Torino, Via Cherasco, 23, 10126 Turin, Italy. · Division of Medical Oncology, Institute for Cancer Research and Treatment, IRCC, Piedmont Oncology Foundation, Strada Provinciale, 142, 10060 Candiolo, Italy. · Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Piazza OMS-Organizzazione Mondiale della Sanità, 1, 24127 Bergamo, Italy. · Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, 20133 Milan, Italy. ·Br J Cancer · Pubmed #24619072.

ABSTRACT: BACKGROUND: Retreatment with ipilimumab has been shown to re-establish disease control in some patients with disease progression. Here, we report the efficacy and safety of retreatment with ipilimumab 3 mg kg(-1) among patients participating in an expanded access programme in Italy. METHODS: Patients who achieved disease control during induction therapy were retreated with ipilimumab upon progression (3 mg kg(-1) every 3 weeks for up to four doses), providing they had not experienced toxicity that precluded further dosing. Tumour assessments were conducted after retreatment, and patients were monitored throughout for adverse events. RESULTS: Of 855 patients treated with ipilimumab, 51 were retreated upon disease progression. Of these, 28 (55%) regained disease control upon retreatment and 42% were alive 2 years after the first induction dose of ipilimumab; median overall survival was 21 months. Eleven patients (22%) had a treatment-related adverse event of any grade during retreatment. These were generally mild-to-moderate and resolved within a median of 4 days. No new types of toxicity were reported. CONCLUSIONS: For patients who meet predefined criteria, retreatment with ipilimumab is generally well tolerated and can translate into clinical benefit. This strategy should be compared with other therapeutic options in randomised controlled trials.

17 Article Factors associated with sentinel lymph node status and prognostic role of completion lymph node dissection for thick melanoma. 2020

Boada, Aram / Tejera-Vaquerizo, Antonio / Ribero, Simone / Puig, Susana / Moreno-Ramírez, David / Quaglino, Pietro / Osella-Abate, Simona / Cassoni, Paola / Malvehy, Josep / Carrera, Cristina / Pigem, Ramon / Barreiro-Capurro, Alicia / Requena, Celia / Traves, Victor / Manrique-Silva, Esperanza / Fernández-Orland, Almudena / Ferrandiz, Lara / García-Senosiain, Oihane / Fernández-Figueras, María T / Ferrándiz, Carlos / Nagore, Edurado / Anonymous2361127. ·Dermatology Department, Hospital Universitari Germans Trial i Pujol, Institut d'investigació en ciències de la salut Germans Trias i Pujol. Badalona, Universitat Autònoma de Barcelona, Spain. Electronic address: aboada.germanstrias@gencat.cat. · Dermatology Department, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, Spain. · Medical Sciences Department, Section of Dermatology, University of Turin, Turin, Italy. · Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Barcelona, Spain. · Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain. · Section of Surgical Pathology, Medical Science Department, University of Turin, Italy. · Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Plastic Surgery Department, Hospital Universitari Germans Trial i Pujol. Badalona, Spain. · Pathology Department, Hospital Universitari Germans Trial i Pujol. Badalona, Spain. · Dermatology Department, Hospital Universitari Germans Trial i Pujol, Institut d'investigació en ciències de la salut Germans Trias i Pujol. Badalona, Universitat Autònoma de Barcelona, Spain. ·Eur J Surg Oncol · Pubmed #31594672.

ABSTRACT: INTRODUCTION: Sentinel lymph node (SLN) biopsy is useful for the prognostic stratification of patients with thick melanoma. Identifying which variables are associated with SLN involvement and establishing risk in different subgroups of patients could be useful for guiding the indication of SLN biopsy. The value of complete lymph node dissection (CLND) in patients with a positive SLN biopsy is currently under debate. MATERIALS AND METHODS: To identify factors associated with SLN involvement in thick melanoma we performed a multicentric retrospective cohort study involving 660 patients with thick melanoma who had undergone SLN biopsy. To analyze the role of CLND in thick melanoma patients with a positive SLN biopsy, we built a multivariate Cox proportional hazards model for melanoma-specific survival (MSS) and disease-free survival (DFS) and compared 217 patients who had undergone CLND with 44 who had not. RESULTS: The logistic regression analysis showed that age, histologic subtype, ulceration, microscopic satellitosis, and lymphovascular invasion were associated with nodal disease. The CHAID (Chi-squared Automatic Interaction Detection) decision tree showed ulceration to be the most important predictor of lymphatic involvement. For nonulcerated melanomas, the histologic subtype lentigo maligna melanoma was associated with a low rate of SLN involvement (4.3%). No significant differences were observed for DFS and MSS between the CLND performed and not-performed groups. Nodal status on CLND was associated with differences in DFS and MSS rates. CONCLUSION: We identified subgroups of thick melanoma patients with a low likelihood of SLN involvement. CLND does not offer survival benefit, but provides prognostic information.

18 Article Clinical and Pathological Relevance of Drug-induced Vitiligo in Patients Treated for Metastatic Melanoma with Anti-PD1 or BRAF/MEK Inhibitors. 2020

Ramondetta, Alice / Ribero, Simone / Conti, Luca / Fava, Paolo / Marra, Elena / Broganelli, Paolo / Caliendo, Virginia / Picciotto, Franco / Guida, Michele / Fierro, Maria Teresa / Quaglino, Pietro. ·Department of Medical Sciences, Dermatologic Clinic, Turin, Italy. ·Acta Derm Venereol · Pubmed #31532537.

ABSTRACT: Current therapies for metastatic melanoma (anti-PD1 and BRAF/MEK inhibitors) can cause drug-induced vitiligo. The aim of this study is to dermatologically define and histologically characterize this new type of vitiligo, and assess the clinical course of the disease. Fourteen patients with metastatic melanoma treated with immune or targeted therapy were included in a dataset evaluating clinical data, vitiligo description and histopathological features. Vitiligo-like lesions occurred after a mean of 7.5 months from the start of the therapies (range 1-42 months), with a prevalence of the non-segmental variant (71.4%). Fifty percent of patients showed a clinical response (4 complete response and 3 partial response), 35.7% had stable disease, and one patient died after disease progression. Median survival from the start of the therapies was 32.5 months. Drug-induced vitiligo can be related to both immune and targeted therapies, is associated with a favourable prognosis, and has clinical characteristics different from the classical form.

19 Article The density and spatial tissue distribution of CD8 2019

Massi, Daniela / Rulli, Eliana / Cossa, Mara / Valeri, Barbara / Rodolfo, Monica / Merelli, Barbara / De Logu, Francesco / Nassini, Romina / Del Vecchio, Michele / Di Guardo, Lorenza / De Penni, Roberta / Guida, Michele / Sileni, Vanna Chiarion / Di Giacomo, Anna Maria / Tucci, Marco / Occelli, Marcella / Portelli, Francesca / Vallacchi, Viviana / Consoli, Francesca / Quaglino, Pietro / Queirolo, Paola / Baroni, Gianna / Carnevale-Schianca, Fabrizio / Cattaneo, Laura / Minisini, Alessandro / Palmieri, Giuseppe / Rivoltini, Licia / Mandalà, Mario / Anonymous1811191. ·Section of Pathological Anatomy, Department of Health Sciences, University of Florence, Florence, Italy. · Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. · Unit of Immunotherapy of Human Tumors, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. · Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. · Unit of Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy. · Unit of Clinical Pharmacology and Oncology, Department of Health Sciences, University of Florence, Florence, Italy. · Unit of Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. · Department of Oncology, Hematology, and Respiratory Diseases, University Hospital of Modena, Modena, Italy. · Department of Medical Oncology and Molecular Genetics Laboratory, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy. · Melanoma and Esophageal Cancer Unit, Istituto Oncologico Veneto-IRCCS, Department of Medical Oncology, Padua, Italy. · Medical Oncology and Immunotherapy, Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy. · Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Bari, Italy. · Azienda Ospedaliera Santa Croce e Carle di Cuneo SC Oncologia, Cuneo, Italy. · Department of Oncology, ASST Spedali Civili, Brescia, Italy. · Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy. · Unit of Medical Oncology, Ospedale Policlinico San Martino, Genoa, Italy. · Medical Oncology Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy. · Division of Pathological Anatomy, Papa Giovanni XXIII Hospital, Bergamo, Italy. · Department of Oncology, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy. · Unit of Cancer Genetics, Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy. · Unit of Immunotherapy of Human Tumors, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. licia.rivoltini@istitutotumori.mi.it. ·J Immunother Cancer · Pubmed #31730502.

ABSTRACT: BACKGROUND: Clinical response to MAPK inhibitors in metastatic melanoma patients is heterogeneous for reasons still needing to be elucidated. As the patient immune activity contributes to treatment clinical benefit, the pre-existing level of immunity at tumor site may provide biomarkers of disease outcome to therapy. Here we investigated whether assessing the density and spatial tissue distribution of key immune cells in the tumor microenvironment could identify patients predisposed to respond to MAPK inhibitors. METHODS: Pretreatment tumor biopsies from a total of 213 patients (158 for the training set and 55 for the validation set) treated with BRAF or BRAF/MEK inhibitors within the Italian Melanoma Intergroup were stained with selected immune markers (CD8, CD163, β-catenin, PD-L1, PD-L2). Results, obtained by blinded immunohistochemical scoring and digital image analysis, were correlated with clinical response and outcome by multivariate logistic models on response to treatment and clinical outcome, adjusted for American Joint Committee on Cancer stage, performance status, lactate dehydrogenase and treatment received. RESULTS: Patients with high intratumoral, but not peritumoral, CD8 CONCLUSIONS: Analysis of the spatially constrained distribution of CD8

20 Article Phenotypic characterisation of immune cells associated with histological regression in cutaneous melanoma. 2019

Osella-Abate, Simona / Conti, Luca / Annaratone, Laura / Senetta, Rebecca / Bertero, Luca / Licciardello, Matteo / Caliendo, Virginia / Picciotto, Franco / Quaglino, Pietro / Cassoni, Paola / Ribero, Simone. ·Department of Medical Sciences, Section of Surgical Pathology, University of Turin, Torino, Italy. · Department of Medical Sciences, Section of Dermatology, University of Turin, Torino, Italy. · Dermatologic Surgery Section, Department of Oncology, AOU Città della Salute e della Scienza di Torino, Torino, Italy. · Department of Medical Sciences, Section of Surgical Pathology, University of Turin, Torino, Italy. Electronic address: paola.cassoni@unito.it. · Department of Medical Sciences, Section of Dermatology, University of Turin, Torino, Italy; Dermatologic Surgery Section, Department of Oncology, AOU Città della Salute e della Scienza di Torino, Torino, Italy. ·Pathology · Pubmed #31266597.

ABSTRACT: Histological regression and tumour infiltrating lymphocytes represent an early sign of activation of the immune system against primary melanoma. The first phenomenon has been especially discussed in the literature because of its prognostic role, but no clear agreement on its evaluation has been reached. Immunotherapy of advanced stage melanoma has recently shown promising results; an improved understanding of the initial interplay between melanoma cells and the immune system would potentially help tailor treatment for patients. Seventy consecutive melanomas with regression were analysed to identify a prognostic cut-off value of regression extension. Then, we compared the immune infiltrate between regressed and not regressed areas of these regressed melanomas, assessing CD3, CD4, CD8, CD20, CD123, PD1 and FOXP3/CD25 expression. The immune infiltrate of these cases was further compared with 28 control melanomas without regression. A regression extension of 10% represented a reliable cut-off to distinguish two different risk categories in regressed melanomas. Regressed areas were less infiltrated by CD4/CD25, FOXP3/CD4 or PD1/CD4 compared to not regressed areas of each sample. These lymphocyte subsets are associated with anergy and hamper the immune CD8+ response towards the cancer cells. Moreover, the relevance of these findings was further supported by the observation that not regressed controls were significantly more infiltrated by these anergic immune cell subsets compared to the regressed cases. These results help understand the real meaning of regression in melanoma. Moreover, the association here identified between specific immunomodulatory immune cell subsets and regression could help in developing new therapeutic strategies.

21 Article Survival analysis and sentinel lymph node status in thin cutaneous melanoma: A multicenter observational study. 2019

Tejera-Vaquerizo, Antonio / Ribero, Simone / Puig, Susana / Boada, Aram / Paradela, Sabela / Moreno-Ramírez, David / Cañueto, Javier / de Unamuno, Blanca / Brinca, Ana / Descalzo-Gallego, Miguel A / Osella-Abate, Simona / Cassoni, Paola / Carrera, Cristina / Vidal-Sicart, Sergi / Bennássar, Antoni / Rull, Ramón / Alos, Llucìa / Requena, Celia / Bolumar, Isidro / Traves, Víctor / Pla, Ángel / Fernández-Orland, A / Jaka, Ane / Fernández-Figueres, María T / Hilari, Josep M / Giménez-Xavier, Pol / Vieira, Ricardo / Botella-Estrada, Rafael / Román-Curto, Concepción / Ferrándiz, Lara / Iglesias-Pena, Nicolás / Ferrándiz, Carlos / Malvehy, Josep / Quaglino, Pietro / Nagore, Eduardo / Anonymous3711174. ·Dermatology Department, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, Spain. · Medical Sciences Department, Section of Dermatology, University of Turin, Turin, Italy. · Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. · Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Barcelona, Spain. · Departamento de Dermatología, Hospital Universitari Germans Trial i Pujol, Badalona, Spain. · Departamento de Dermatología, Hospital Universitario de la Coruña, La Coruña, Spain. · Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain. · Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain. · Instituto de Investigación Biomédica de Salamanca, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain. · Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain. · Department of Dermatology, University Hospital of Coimbra, Coimbra, Portugal. · Unidad de Investigación, Academia Española de Dermatología, Fundación Piel Sana, Madrid, Spain. · Medical Sciences Department, Section of Surgical Pathology, University of Turin, Turin, Italy. · Nuclear Medicine Department, Hospital Clinic Barcelona, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. · Surgery Department, Hospital Clinic, Barcelona, Spain. · Pathology Department, Hospital Clinic, Universidad de Barcelona, Barcelona, Spain. · Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Surgery Department, Instituto Valenciano de Oncología, Valencia, Spain. · Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Otorhinolaringology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Pathology Department, Hospital Universitari Germans Trial i Pujol, Badalona, Spain. ·Cancer Med · Pubmed #31215168.

ABSTRACT: Mitotic rate is no longer considered a staging criterion for thin melanoma in the 8th edition of the American Joint Committee on Cancer Staging Manual. The aim of this observational study was to identify prognostic factors for thin melanoma and predictors and prognostic significance of sentinel lymph node (SLN) involvement in a large multicenter cohort of patients with melanoma from nine tertiary care hospitals. A total of 4249 consecutive patients with thin melanoma diagnosed from January 1, 1998 to December 31, 2016 were included. The main outcomes were disease-free interval and melanoma-specific survival for the overall population and predictors of SLN metastasis (n = 1083). Associations between survival and SLN status and different clinical and pathologic variables (sex, age, tumor location, mitosis, ulceration, regression, lymphovascular invasion, histologic subtype, Clark level, and Breslow thickness) were analyzed by Cox proportional hazards regression and logistic regression. SLN status was the most important prognostic factor for melanoma-specific survival (hazard ratio, 13.8; 95% CI, 6.1-31.2; P < 0.001), followed by sex, ulceration, and Clark level for patients who underwent SLNB. A mitotic rate of >2 mitoses/mm

22 Article Can sentinel node biopsy be safely omitted in thin melanoma? Risk factor analysis of 1272 multicenter prospective cases. 2019

Piazzalunga, Dario / Ceresoli, Marco / Allievi, Niccolò / Ribero, Simone / Quaglino, Pietro / Di Lorenzo, Sara / Corradino, Bartolo / Campana, Luca Giovanni / Mocellin, Simone / Rossi, Carlo Riccardo / Anonymous660972. ·General Surgery Unit, Papa Giovanni XXIII Hospital, piazza OMS 1, 24127, Bergamo, Italy. · General Surgery Unit, Papa Giovanni XXIII Hospital, piazza OMS 1, 24127, Bergamo, Italy. Electronic address: marco.ceresoli@libero.it. · Medical Sciences Department, Dermatologic Clinic, University of Torino, Via Cherasco 23, 10126, Torino, Italy. · Surgical, Oncological and Stomatologic Disciplines, Plastic Surgery Unit, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy. · Veneto Institute of Oncology IOV-IRCCS, Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, Via Gattamelata, 64, 35128, Padova, Italy. ·Eur J Surg Oncol · Pubmed #30527782.

ABSTRACT: BACKGROUND: The indication to sentinel node biopsy (SNB) for thin melanomas (Breslow <1 mm) is still subject to controversies. The aim of this paper is to review all SNB performed for thin melanoma and to analyze factors related to lymphatic metastasis. Moreover, the diagnostic performance of the 5th, 6th, 7th and 8th AJCC classifications for cutaneous melanoma were investigated. METHODS: All sentinel node biopsies performed for thin melanomas were selected from a multicentre prospectively-collected database. For each patient the following was collected: age, sex, date of treatment, site of primary melanoma, histopathologic features (Breslow, Clark, number of mitoses/mm RESULTS: From 1998 to 2017 were performed a total of 1272 SNB for thin melanoma. Mean age was 51years with 48.7% of male patients. Overall, 5.6% positive SNB were found. At univariate and multivariate analyses, Breslow thickness and ulceration were related to the presence of lymphatic metastasis. We compared the four versions of the AJCC classification: among pT1a patients there were respectively 5.32%, 5.63%, 3.72% and 3.49% of positive SNB. CONCLUSIONS: in thin melanoma Breslow thickness and ulceration were the only factors related to a positive SNB. Although convincing improvements resulted from the implementation of AJCC classifications with a reduction of positive biopsies among pT1a, a 10.71% rate among all positive nodes remains in the low-risk group. No recommendations can be drawn from this research and adjunctive evidences are needed to better identify patients at risk of nodal metastasis.

23 Article Prognostic impact of regression in patients with primary cutaneous melanoma >1 mm in thickness. 2019

Ribero, Simone / Galli, Francesca / Osella-Abate, Simona / Bertero, Luca / Cattaneo, Laura / Merelli, Barbara / Tondini, Carlo / Ghilardi, Laura / De Giorgi, Vincenzo / Occelli, Marcella / Quaglino, Pietro / Cassoni, Paola / Palmieri, Giuseppe / Massi, Daniela / Mandala, Mario / Anonymous23290969. ·Section of Dermatology, Medical Sciences Department, University of Turin, Turin, Italy. · Methodology for Clinical Research Laboratory, Instituto di Ricovero e Cura a Carattere Scientifico, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. · Section of Surgical Pathology, Medical Sciences Department, University of Turin, Turin, Italy. · Unit of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy. · Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Bergamo, Italy. · Department of Dermatology, University of Florence, Florence, Italy. · Azienda Ospedaliera Santa Croce e Carle di Cuneo SC Oncologia, Cuneo, Italy. · Unit of Cancer Genetics, Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy. · Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Bergamo, Italy. Electronic address: mariomandala@tin.it. ·J Am Acad Dermatol · Pubmed #30447951.

ABSTRACT: BACKGROUND: The impact of histologic regression on sentinel lymph node biopsy (SLNB) status and on clinical outcome is uncertain. OBJECTIVE: To investigate whether and to what extent regression <75% is able to predict SLNB status and clinical outcome of patients with melanoma >1-mm thick. METHODS: The study included patients with diagnoses given at 4 centers of the Italian Melanoma Intergroup. Univariate and multivariate Cox proportional hazard models stratified by center were used to analyze the effect of regression on disease-free interval and melanoma-specific survival. RESULTS: Out of 1182 patients given primary cutaneous melanoma diagnoses during 1998-2015 with a Breslow thickness >1 mm, 954 (304 with and 650 without regression) were included in the analysis. The proportion of patients with a positive SLNB was lower in patients with regression than without (24.4% vs 31.6%, chi-squared test P = .0368). At multivariate analysis, no association was detected between regression and disease-free interval (hazard ratio 1.11, 95% confidence interval 0.85-1.46; P = .4509) or melanoma-specific survival (hazard ratio 1.05, 95% confidence interval 0.77-1.44; P = .7600). LIMITATION: Retrospective analysis. CONCLUSION: In our series, regression was not an independent prognostic factor in primary cutaneous melanoma patients with Breslow thickness >1 mm whereas it was associated with a lower incidence of SLNB positivity.

24 Article Soluble CTLA-4 as a favorable predictive biomarker in metastatic melanoma patients treated with ipilimumab: an Italian melanoma intergroup study. 2019

Pistillo, Maria Pia / Fontana, Vincenzo / Morabito, Anna / Dozin, Beatrice / Laurent, Stefania / Carosio, Roberta / Banelli, Barbara / Ferrero, Francesca / Spano, Laura / Tanda, Enrica / Ferrucci, Pier Francesco / Martinoli, Chiara / Cocorocchio, Emilia / Guida, Michele / Tommasi, Stefania / De Galitiis, Federica / Pagani, Elena / Antonini Cappellini, Gian Carlo / Marchetti, Paolo / Quaglino, Pietro / Fava, Paolo / Osella-Abate, Simona / Ascierto, Paolo Antonio / Capone, Mariaelena / Simeone, Ester / Romani, Massimo / Spagnolo, Francesco / Queirolo, Paola / Anonymous8380964. ·Unit of Tumor Epigenetics, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy. mariapia.pistillo@hsanmartino.it. · Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. · Unit of Tumor Epigenetics, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy. · Department of Internal Medicine, University of Genoa, Genoa, Italy. · Department of Health Sciences, University of Genoa, Genoa, Italy. · Department of Medical Oncology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. · Oncology of Melanoma Unit, European Institute of Oncology, Milan, Italy. · iTeos Therapeutics, Gosselies, Belgium. · Department of Medical Oncology and Molecular Genetics Laboratory, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy. · Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy. · Sapienza University of Rome, Rome, Italy. · Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy. · Department of Medical Sciences, Section of Surgical Pathology, University of Turin, Turin, Italy. · Melanoma, Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori Fondazione'G. Pascale', Naples, Italy. ·Cancer Immunol Immunother · Pubmed #30311027.

ABSTRACT: CTLA-4 blockade by means of ipilimumab (IPI) potentiates the immune response and improves overall survival (OS) in a minority of metastatic melanoma (MM) patients. We investigated the role of soluble CTLA-4 (sCTLA-4) as a possible biomarker for identifying this subset of patients. sCTLA-4 levels were analyzed at baseline in sera from 113 IPI-treated MM patients by ELISA, and the median value (200 pg/ml) was used to create two equally sized subgroups. Associations of sCTLA-4 with best overall response (BOR) to IPI and immune-related adverse events (irAEs) were evaluated through logistic regression. Kaplan-Meier and Cox regression methods were used to analyze OS. A remarkable association between sCTLA-4 levels and BOR was found. Specifically, the proportion of patients with sCTLA-4 > 200 pg/ml in irSD or irPD (immune-related stable or progressive disease) was, respectively, 80% (OR = 0.23; 95%CL = 0.03-1.88) and 89% (OR = 0.11; 95%CL = 0.02-0.71) and was lower than that observed among patients in irCR/irPR (immune-related complete/partial response). sCTLA-4 levels increased during IPI treatment, since the proportion of patients showing sCTLA > 200 pg/ml after 3 cycles was 4 times higher (OR = 4.41, 95%CL = 1.02-19.1) than that after 1 cycle. Moreover, a significantly lower death rate was estimated for patients with sCTLA-4 > 200 pg/ml (HR = 0.61, 95%CL = 0.39-0.98). Higher baseline sCTLA-4 levels were also associated with the onset of any irAE (p value = 0.029), in particular irAEs of the digestive tract (p value = 0.041). In conclusion, our results suggest that high sCTLA-4 serum levels might predict favorable clinical outcome and higher risk of irAEs in IPI-treated MM patients.

25 Article BRAFi/MEKi in patients with metastatic melanoma: predictive factors of complete response. 2019

Ribero, Simone / Malavenda, Ottavia / Fava, Paolo / Astrua, Chiara / Marra, Elena / Osella-Abate, Simona / Sanlorenzo, Martina / Caliendo, Virginia / Fierro, Maria Teresa / Quaglino, Pietro. ·Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy. · Faculty of Medicine, University of Turin, Turin, Italy. · Department of Medicine I, Institute of Cancer Research, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. · Department of Oncology, Section of Dermatologic Surgery, University Hospital Citta della Scienza e della Salute di Torino, Turin, Italy. ·Future Oncol · Pubmed #30196713.

ABSTRACT: AIM: A survival benefit was demonstrated by dabrafenib + trametinib for metastatic BRAF-mutated melanoma patients. Best response is a strong prognostic marker for survival. PATIENTS & METHODS: The specific features associated with complete response (CR) were evaluated. RESULTS: A total of 15/66 patients achieved CR. Median size of lesions was 3 cm (range: 0.5-10). Using that value as cut-off, the CR rate was 39.3% in patients with smaller lesions and 10.5% in patients with bigger size (p = 0.006). The clinical features associated with CR were the number of metastatic sites and the largest diameter of the biggest metastatic site. CONCLUSION: The number of the metastases and the diameter of the largest metastatic site are associated with a higher CR rate.

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