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Melanoma: HELP
Articles from Melanoma Institute Australia
Based on 354 articles published since 2008
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These are the 354 published articles about Melanoma that originated from Melanoma Institute Australia during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15
1 Guideline Data set for pathology reporting of cutaneous invasive melanoma: recommendations from the international collaboration on cancer reporting (ICCR). 2013

Scolyer, Richard A / Judge, Meagan J / Evans, Alan / Frishberg, David P / Prieto, Victor G / Thompson, John F / Trotter, Martin J / Walsh, Maureen Y / Walsh, Noreen M G / Ellis, David W / Anonymous3190770. ·*Melanoma Institute Australia Disciplines of †Pathology **Surgery, Sydney Medical School, The University of Sydney Departments of ‡Tissue Pathology and Diagnostic Oncology ††Melanoma and Surgical Oncology, Royal Prince Alfred Hospital §Royal College of Pathologists of Australasia, Sydney, NSW ¶¶Royal Adelaide Hospital and Flinders University, Adelaide, SA, Australia ∥Department of Pathology, Ninewells Hospital and Medical School, Dundee, Scotland ¶Cedars-Sinai Medical Center, Los Angeles, CA #Departments of Pathology and Dermatology, University of Texas-MD Anderson Cancer Center, Houston, TX ‡‡Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB ∥∥Department of Pathology, Capital District Health Authority and Dalhousie University, Halifax, NS, Canada §§Royal Victoria Hospital, Belfast, UK. ·Am J Surg Pathol · Pubmed #24061524.

ABSTRACT: An accurate and complete pathology report is critical for the optimal management of cutaneous melanoma patients. Protocols for the pathologic reporting of melanoma have been independently developed by the Royal College of Pathologists of Australasia (RCPA), Royal College of Pathologists (United Kingdom) (RCPath), and College of American Pathologists (CAP). In this study, data sets, checklists, and structured reporting protocols for pathologic examination and reporting of cutaneous melanoma were analyzed by an international panel of melanoma pathologists and clinicians with the aim of developing a common, internationally agreed upon, evidence-based data set. The International Collaboration on Cancer Reporting cutaneous melanoma expert review panel analyzed the existing RCPA, RCPath, and CAP data sets to develop a protocol containing "required" (mandatory/core) and "recommended" (nonmandatory/noncore) elements. Required elements were defined as those that had agreed evidentiary support at National Health and Medical Research Council level III-2 level of evidence or above and that were unanimously agreed upon by the review panel to be essential for the clinical management, staging, or assessment of the prognosis of melanoma or fundamental for pathologic diagnosis. Recommended elements were those considered to be clinically important and recommended for good practice but with lesser degrees of supportive evidence. Sixteen core/required data elements for cutaneous melanoma pathology reports were defined (with an additional 4 core/required elements for specimens received with lymph nodes). Eighteen additional data elements with a lesser level of evidentiary support were included in the recommended data set. Consensus response values (permitted responses) were formulated for each data item. Development and agreement of this evidence-based protocol at an international level was accomplished in a timely and efficient manner, and the processes described herein may facilitate the development of protocols for other tumor types. Widespread utilization of an internationally agreed upon, structured pathology data set for melanoma will lead not only to improved patient management but is a prerequisite for research and for international benchmarking in health care.

2 Editorial When is surgery for metastatic melanoma still the most appropriate treatment option? 2018

Friedman, Erica B / Ferguson, Peter M / Thompson, John F. ·a Melanoma Institute Australia , The University of Sydney , North Sydney , Australia. · b Department of Tissue Pathology and Diagnostic Oncology , Royal Prince Alfred Hospital , Camperdown , Australia. · d The Faculty of Medicine and Health , The University of Sydney , Sydney , NSW , Australia. · c Department of Melanoma and Surgical Oncology , Royal Prince Alfred Hospital , Camperdown , NSW , Australia. ·Expert Rev Anticancer Ther · Pubmed #30071762.

ABSTRACT: -- No abstract --

3 Editorial Melanoma Staging: American Joint Committee on Cancer (AJCC) 8th Edition and Beyond. 2018

Gershenwald, Jeffrey E / Scolyer, Richard A. ·Departments of Surgical Oncology and Cancer Biology, Unit 1484, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. jgershen@mdanderson.org. · Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. jgershen@mdanderson.org. · Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. · Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. · Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. ·Ann Surg Oncol · Pubmed #29850954.

ABSTRACT: -- No abstract --

4 Editorial Prognostic features for acral lentiginous melanoma. 2018

Cust, A E. ·Sydney School of Public Health and Melanoma Institute Australia, The University of Sydney, Australia. ·Br J Dermatol · Pubmed #29441559.

ABSTRACT: -- No abstract --

5 Editorial Advances in melanoma: revolutionary progress delivering improved patient management and outcomes. 2016

Scolyer, Richard A / Vilain, Ricardo E / Mihm, Martin C. ·Melanoma Institute Australia, North Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, Australia; Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia. Electronic address: richard.scolyer@sswahs.nsw.gov.au. · School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, Callaghan, Australia; Hunter Cancer Research Alliance (HCRA), Calvary Mater Newcastle, Waratah, Australia; Division of Anatomical Pathology, Pathology North (Hunter), New Lambton Heights, NSW, Australia. · Harvard Skin Disease Research Center, Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. ·Pathology · Pubmed #27020382.

ABSTRACT: -- No abstract --

6 Editorial Is chemotherapy still an option in the treatment of melanoma? 2015

Carlino, M S / Long, G V. ·Melanoma Institute Australia, Sydney The Sydney Medical School, The University of Sydney, Sydney Department of Medical Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney. · Melanoma Institute Australia, Sydney The Sydney Medical School, The University of Sydney, Sydney The Mater Hospital, North Sydney, Australia georgina.long@sydney.edu.au. ·Ann Oncol · Pubmed #26374287.

ABSTRACT: -- No abstract --

7 Editorial From dismal prognosis to rising star: melanoma leading the way with new generation cancer therapies. 2015

Long, Georgina V. ·Melanoma Institute Australia, Sydney, NSW, Australia. Georgina.Long@sydney.edu.au. ·Med J Aust · Pubmed #25669459.

ABSTRACT: -- No abstract --

8 Editorial Sentinel lymph node biopsy for melanoma: a plea to let the data be heard. 2014

Thompson, John F / Faries, Mark B / Cochran, Alistair J. ·Melanoma Institute Australia and the University of Sydney, Sydney, NSW, Australia, john.thompson@melanoma.org.au. ·Ann Surg Oncol · Pubmed #25103536.

ABSTRACT: -- No abstract --

9 Editorial Local and regional therapies for melanoma: many arrows in the quiver. 2014

Thompson, John F. ·Melanoma Institute Australia, North Sydney, New South Wales, Australia. ·J Surg Oncol · Pubmed #24419862.

ABSTRACT: -- No abstract --

10 Review Re-examining the role of adjuvant radiation therapy. 2019

Spillane, Andrew / Hong, Angela / Fogarty, Gerald. ·Surgical Oncology, Northern Clinical School, The University of Sydney, Sydney, Australia. · Melanoma Institute Australia, Sydney, Australia. · Melanoma Unit, Mater Hospital, Sydney, Australia. · Royal North Shore Hospital, Sydney, Australia. · Radiation Oncology, Royal Prince Alfred Hospital, Sydney, Australia. · Radiation Oncology, GenesisCare, Mater Radiation Oncology, Sydney, Australia. · Radiation Oncology, St Vincents Hospital, Sydney, Australia. ·J Surg Oncol · Pubmed #30554414.

ABSTRACT: Previously important roles for adjuvant radiotherapy (RT) in melanoma patients included improved regional control after resection of high-risk nodal disease, to reduce local recurrence for desmoplastic, and other subtypes of melanoma with neurotropism, reducing in-brain relapse of brain metastases after surgery and other situations on a case-by-case basis. This review evaluates the integration of adjuvant RT into clinical practice at this time of rapidly evolving knowledge and improving outcomes from effective systemic therapy.

11 Review Oncogenic signaling in uveal melanoma. 2018

Park, John J / Diefenbach, Russell J / Joshua, Anthony M / Kefford, Richard F / Carlino, Matteo S / Rizos, Helen. ·Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia. · Melanoma Institute Australia, Sydney, New South Wales, Australia. · Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, New South Wales, Australia. · Department of Medical Oncology, Crown Princess Mary Cancer Centre, Westmead and Blacktown Hospitals, Sydney, New South Wales, Australia. ·Pigment Cell Melanoma Res · Pubmed #29738114.

ABSTRACT: Uveal melanoma is the most common primary cancer of the eye, and despite rapidly emerging insights into the molecular profile of this disease, prognosis of patients with metastatic uveal melanoma remains poor with mortality rates unchanged in over 35 years. Early genetic events activate G protein-coupled receptor signaling in nearly all uveal tumors via mutually exclusive mutations in the GNAQ, GNA11, CYSLTR2, or PLCB4 genes. A multitude of signaling cascades downstream of G protein activation, including protein kinase C and mitogen-activated protein kinase activity, are actionable, and many ongoing clinical trials are targeting these pathways. Additional cytogenetic and genetic changes, however, including chromosome 3 monosomy, mutations in the BAP1 tumor suppressor gene, alterations in the splicing factors SRSF2/SF3B1, and mutations in the translation initiation factor EIF1AX, modulate signaling output in uveal tumors and modify the risk of metastases. Here, we review the complex interactions between genetic, molecular signaling, and prognostic profiles in uveal melanoma; the clinical implications of these interactions; and the latest potential targets for rational therapy.

12 Review Liquid biomarkers in melanoma: detection and discovery. 2018

Lim, Su Yin / Lee, Jenny H / Diefenbach, Russell J / Kefford, Richard F / Rizos, Helen. ·Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia. · Melanoma Institute Australia, Sydney, NSW, Australia. · Department of Medical Oncology, Crown Princess Mary Cancer Centre, Westmead and Blacktown Hospitals, Sydney, NSW, Australia. · Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia. Helen.rizos@mq.edu.au. · Melanoma Institute Australia, Sydney, NSW, Australia. Helen.rizos@mq.edu.au. · Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, 2 Technology Place, Sydney, NSW, 2109, Australia. Helen.rizos@mq.edu.au. ·Mol Cancer · Pubmed #29343260.

ABSTRACT: A vast array of tumor-derived genetic, proteomic and cellular components are constantly released into the circulation of cancer patients. These molecules including circulating tumor DNA and RNA, proteins, tumor and immune cells are emerging as convenient and accurate liquid biomarkers of cancer. Circulating cancer biomarkers provide invaluable information on cancer detection and diagnosis, prognosticate patient outcomes, and predict treatment response. In this era of effective molecular targeted treatments and immunotherapies, there is now an urgent need to implement use of these circulating biomarkers in the clinic to facilitate personalized therapy. In this review, we present recent findings in circulating melanoma biomarkers, examine the challenges and promise of evolving technologies used for liquid biomarker discovery, and discuss future directions and perspectives in melanoma biomarker research.

13 Review Impact of genomics on the surgical management of melanoma. 2018

Ferguson, P M / Long, G V / Scolyer, R A / Thompson, J F. ·Melanoma Institute Australia, Sydney, New South Wales, Australia. · Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. · Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. · Department of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia. · Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. ·Br J Surg · Pubmed #29341162.

ABSTRACT: BACKGROUND: Although surgery for early-stage melanoma offers the best chance of cure, recent advances in molecular medicine have revolutionized the management of late-stage melanoma, leading to significant improvements in clinical outcomes. Research into the genomic drivers of disease and cancer immunology has not only ushered in a new era of targeted and immune-based therapies for patients with metastatic melanoma, but has also provided new tools for monitoring disease recurrence and selecting therapeutic strategies. These advances present new opportunities and challenges to the surgeon treating patients with melanoma. METHODS: The literature was reviewed to evaluate diagnostic and therapeutic advances in the management of cutaneous melanoma, and to highlight the impact of these advances on surgical decision-making. RESULTS: Genomic testing is not required in the surgical management of primary melanoma, although it can provide useful information in some situations. Circulating nucleic acids from melanoma cells can be detected in peripheral blood to predict disease recurrence before it manifests clinically, but validation is required before routine clinical application. BRAF mutation testing is the standard of care for all patients with advanced disease to guide therapy, including the planning of surgery in adjuvant and neoadjuvant settings. CONCLUSION: Surgery remains central for managing primary melanoma, and is an important element of integrated multidisciplinary care in advanced disease, particularly for patients with resectable metastases. The field will undergo further change as clinical trials address the relationships between surgery, radiotherapy and systemic therapy for patients with high-risk, early-stage and advanced melanoma.

14 Review Melanoma and nonmelanoma skin cancer chemoprevention: A role for nicotinamide? 2018

Minocha, Rashi / Damian, Diona L / Halliday, Gary M. ·Discipline of Dermatology, Bosch Institute, Central Clinical School, University of Sydney, Sydney, NSW, Australia. · Dermatology, Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia. · Melanoma Institute Australia, North Sydney, NSW, Australia. ·Photodermatol Photoimmunol Photomed · Pubmed #28681504.

ABSTRACT: Ultraviolet radiation (UVR) causes DNA damage in melanocytes by producing photolesions such as cyclobutane pyrimidine dimers and 8-oxo-7-hydrodeoxyguanosine. The production of reactive oxygen species by UVR also induces inflammatory cytokines that, together with the inherent immunosuppressive properties of UVR, propagate carcinogenesis. Nicotinamide (Vitamin B

15 Review Radiological manifestations of immune-related adverse effects observed in patients with melanoma undergoing immunotherapy. 2017

Sidhu, Parveen / Menzies, Alexander M / Long, Georgina / Carlino, Matteo / Lorens, Shirleen / Kapoor, Rony. ·Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. · Melanoma Institute Australia, North Sydney, New South Wales, Australia. · Royal North Shore Hospital, Sydney, New South Wales, Australia. · University of Notre Dame Sydney, Darlinghurst, New South Wales, Australia. ·J Med Imaging Radiat Oncol · Pubmed #29024572.

ABSTRACT: Immunotherapy drugs work by stimulating the patient's own immune system to recognize and destroy cancer cells. This subclass of drugs is increasingly administered to patients with advanced melanoma. They are also commonly incorporated into other cancer therapies such as non-small cell lung cancer, renal cancer, head and neck cancers and Hodgkin lymphoma. The most commonly administered immunotherapeutic agents in the treatment of melanoma include programmed cell death protein 1 (PD-1) inhibitors, cytotoxic T-lymphocyte antigen 4 (CTLA-4) inhibitors and a subclass of cytokines. During treatment with these antibodies, a unique set of adverse effects may occur which are often called immune-related adverse events (irAEs). It is vital for radiologists to be aware of and document these side effects during routine staging or body imaging during therapy. Some of these include pneumonitis, colitis, hypophysitis, lymphadenopathy or sarcoid-like syndrome and myositis. IrAEs such as sarcoid-like lymphadenopathy can mimic progression of disease. Serious side effects are seen in less than 10% of patients, and typically emerge between 6 and 12 weeks after commencing treatment. The clinical manifestations of these side effects typically vary from mild to severe and so do the radiological findings. Patients with mild side effects are often treated successfully with systemic corticosteroids, while severe cases require cessation of immunotherapy. We provide a pictorial article on the common irAEs and the associated radiological manifestations.

16 Review Survival of patients with advanced metastatic melanoma: the impact of novel therapies-update 2017. 2017

Ugurel, Selma / Röhmel, Joachim / Ascierto, Paolo A / Flaherty, Keith T / Grob, Jean Jacques / Hauschild, Axel / Larkin, James / Long, Georgina V / Lorigan, Paul / McArthur, Grant A / Ribas, Antoni / Robert, Caroline / Schadendorf, Dirk / Garbe, Claus. ·Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. Electronic address: selma.ugurel@uk-essen.de. · Bremen, Germany. · Melanoma, Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori Fondazione "G. Pascale", Naples, Italy. · Massachusetts General Hospital, Boston, MA, USA. · Department of Dermatology, Timone Hospital and Aix-Marseille University, Marseille, France. · Department of Dermatology, University Hospital of Schleswig-Holstein, Kiel, Germany. · Royal Marsden Hospital NHS Foundation Trust, London, UK. · Melanoma Institute Australia, The University of Sydney, and Royal North Shore Hospital, Sydney, NSW, Australia. · University of Manchester, The Christie NHS Foundation Trust, Manchester, UK. · Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia and University of Melbourne, Parkville, VIC, Australia. · University of California, Los Angeles, CA, USA. · Gustave Roussy Cancer Campus, Villejuif Grand-Paris, France. · Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. · Center for Dermatooncology, Department of Dermatology, University of Tuebingen, Tuebingen, Germany. ·Eur J Cancer · Pubmed #28756137.

ABSTRACT: The treatment of metastatic melanoma is still undergoing a process of major change. The two most important novel therapeutic strategies, selective kinase inhibitors and immune checkpoint blockers, both significantly prolong survival times of patients with advanced metastatic disease. Different agents, dose regimens and combinations have been tested against each other vigorously within these two groups. However, results from prospective head-to-head comparative studies of both strategies are still lacking. We performed an exploratory analysis of survival data from selected clinical trials representative for the new treatment strategies in advanced metastatic melanoma. Eighty-three Kaplan-Meier survival curves from 25 trials were digitised and grouped by therapeutic strategy and treatment line. For each of these groups, mean survival curves were generated for progression-free (PFS) and overall survival (OS) by weighted averaging. Survival curves grouped together by therapeutic strategy revealed a high concordance, particularly in the first-line setting. For kinase inhibitors, the most favourable PFS and OS in all therapy lines were observed for combined BRAF plus MEK inhibition. For immune checkpoint inhibitors, combined PD-1 plus CTLA-4 inhibition demonstrated the best survival outcome in all categories except for OS in first-line therapy. For the latter, combined PD-1 plus CTLA-4 inhibition showed similar outcomes as single-agent PD-1 inhibition. Comparison of kinase inhibitors and checkpoint blockers revealed a superiority of combined BRAF plus MEK inhibition within the first 6 months, later changing to a superiority of PD-1 blockers alone or in combination with CTLA-4 blockers. These results need confirmation by prospective clinical trials.

17 Review When is a sentinel node biopsy indicated for patients with primary melanoma? An update of the 'Australian guidelines for the management of cutaneous melanoma'. 2017

Gyorki, David E / Barbour, Andrew / Hanikeri, Mark / Mar, Victoria / Sandhu, Shahneen / Thompson, John F. ·Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. · Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia. · Upper Gastrointestinal and Soft Tissue Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia. · Surgical Oncology Laboratory, Discipline of Surgery, University of Queensland, Brisbane, Queensland, Australia. · Western Australia Melanoma Advisory Service, Perth, Western Australia, Australia. · Victorian Melanoma Service, Alfred Hospital, Melbourne, Victoria, Australia. · Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. · Skin and Cancer Foundation Inc., Melbourne, Victoria, Australia. · Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. · Melanoma Institute Australia, Poche Centre, Sydney, New South Wales, Australia. · Discipline of Surgery, University of Sydney, Sydney, New South Wales, Australia. · Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. ·Australas J Dermatol · Pubmed #28718222.

ABSTRACT: A sentinel lymph node biopsy is a surgical staging procedure performed for patients with primary cutaneous melanoma who are clinically lymph-node negative to determine whether there is low volume nodal metastasis in the draining lymph node field. A systematic review was recently performed to update the Australian clinical practice guidelines for the diagnosis and management of melanoma, addressing the question, 'When is a sentinel lymph node biopsy indicated?' This article discusses the findings of the systematic review and the evidence base for the updated guidelines.

18 Review Role of sentinel lymph node biopsy as a staging procedure in patients with melanoma: A critical appraisal. 2017

Nieweg, Omgo E / Cooper, Alan / Thompson, John F. ·Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia. · Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. · Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. · Department of Dermatology, Royal North Shore Hospital, Sydney, New South Wales, Australia. · Sydney Medical School - Northern, University of Sydney, Sydney, New South Wales, Australia. ·Australas J Dermatol · Pubmed #28707391.

ABSTRACT: Worldwide, sentinel node (SN) biopsy for accurate staging is now part of the standard work-up of patients with melanomas ≥1.0 mm Breslow thickness, as it is for staging patients with breast cancer. Nuclear medicine imaging and surgical techniques have evolved to such a degree that a SN can be identified and removed in virtually every patient. Nevertheless, some opposition to a routine SN biopsy remains, perhaps due to a failure to appreciate the serious implications of incomplete or inaccurate staging. Guided by a critical appraisal of the available evidence, this review elucidates the definition of an SN, discusses the sensitivity and specificity of the information it provides, emphasises that it is a minor staging procedure that can lead to improved survival when followed by appropriate therapy, and explains the necessarily unconventional and complex design of the only randomised trial that addresses this subject. It also describes other benefits and risks of an SN biopsy and outlines its role in current melanoma management.

19 Review Melanoma patient imaging in the era of effective systemic therapies. 2017

Stodell, M / Thompson, J F / Emmett, L / Uren, R F / Kapoor, R / Saw, R P M. ·Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. · Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Discipline of Surgery, The University of Sydney, Sydney, NSW, Australia; Division of Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. · Garvan Institute of Medical Research, Discipline of Medicine, The University of New South Wales, Sydney, NSW, Australia. · Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Alfred Nuclear Medicine and Ultrasound, Newtown, NSW, Australia. · Mater Imaging, The Mater Hospital Sydney, North Sydney, NSW, Australia. · Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Discipline of Surgery, The University of Sydney, Sydney, NSW, Australia; Division of Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. Electronic address: robyn.saw@melanoma.org.au. ·Eur J Surg Oncol · Pubmed #28625798.

ABSTRACT: Imaging plays a critical role in the current multi-disciplinary management of patients with melanoma. It is used for primary disease staging, surgical planning, and surveillance in high-risk patients, and for monitoring the effects of systemic or loco-regional therapies. Several different imaging modalities have been utilised in the past. Contemporary imaging practises vary geographically depending on clinical guidelines, physician preferences, availability and cost. Targeted therapies and immunotherapies have revolutionised the treatment of patients with metastatic melanoma over the last few years. With this have come new patterns of disease that were not observed after conventional therapies, and new criteria to assess therapeutic responses. In this article we review the role of imaging for patients with melanoma in the era of effective systemic therapies and discuss likely future developments.

20 Review Mechanisms and strategies to overcome resistance to molecularly targeted therapy for melanoma. 2017

Lim, Su Yin / Menzies, Alexander M / Rizos, Helen. ·Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia. · Melanoma Institute Australia, Sydney, New South Wales, Australia. · Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. · Royal North Shore Hospital, Sydney, New South Wales, Australia. ·Cancer · Pubmed #28543695.

ABSTRACT: The identification of driver mutations in melanoma has changed the field of cancer treatment. BRAF and NRAS mutations are predominant in melanoma and lead to overactivation of the mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathways. Selective inhibitors targeting key effectors of the MAPK pathway have revolutionized the treatment of patients with advanced metastatic BRAF-mutant melanoma. However, resistance to therapy is almost universal and remains a major challenge in clinical care, with the majority of patients progressing within 1 year. Dissecting the mechanisms of resistance to targeted therapies may offer new insights into strategies for overcoming resistance. This review describes the efficacy of therapies targeting the MAPK and PI3K/AKT signaling pathways in melanoma, details the mechanisms contributing to drug resistance, and discusses current approaches to improving outcomes further. Cancer 2017;123:2118-29. © 2017 American Cancer Society.

21 Review Sun exposure and skin cancer, and the puzzle of cutaneous melanoma: A perspective on Fears et al. Mathematical models of age and ultraviolet effects on the incidence of skin cancer among whites in the United States. American Journal of Epidemiology 1977; 105: 420-427. 2017

Armstrong, Bruce K / Cust, Anne E. ·Cancer Epidemiology and Prevention Research Group, School of Public Health, The University of Sydney, NSW, Australia; School of Global and Population Health, The University of Western Australia, Perth, WA, Australia. Electronic address: bruce.armstrong@uwa.edu.au. · Cancer Epidemiology and Prevention Research Group, School of Public Health, The University of Sydney, NSW, Australia; The Melanoma Institute Australia, North Sydney, NSW, Australia. ·Cancer Epidemiol · Pubmed #28478931.

ABSTRACT: Sunlight has been known as an important cause of skin cancer since around the turn of the 20th Century. A 1977 landmark paper of US scientists Fears, Scotto, and Schneiderman advanced a novel hypothesis whereby cutaneous melanoma was primarily caused by intermittent sun exposure (i.e. periodic, brief episodes of exposure to high-intensity ultraviolet radiation) while the keratinocyte cancers, squamous cell carcinoma and basal cell carcinoma, were primarily caused by progressive accumulation of sun exposure. With respect to cutaneous melanoma, this became known as the intermittent exposure hypothesis. The hypothesis stemmed from analysis of measured ambient ultraviolet radiation and age-specific incidence rates of melanoma and keratinocyte cancers collected as an extension to the US Third National Cancer Survey in several US States. In this perspective paper, we put this novel hypothesis into the context of knowledge at the time, and describe subsequent epidemiological and molecular research into melanoma that elaborated the intermittent exposure hypothesis and ultimately replaced it with a dual pathway hypothesis. Our present understanding is of two distinct biological pathways by which cutaneous melanoma might develop; a nevus prone pathway initiated by early sun exposure and promoted by intermittent sun exposure or possibly host factors; and a chronic sun exposure pathway in sun sensitive people who progressively accumulate sun exposure to the sites of future melanomas.

22 Review Immune Checkpoint Inhibitors for Brain Metastases. 2017

Tan, Aaron C / Heimberger, Amy B / Menzies, Alexander M / Pavlakis, Nick / Khasraw, Mustafa. ·Royal North Shore Hospital, St Leonards, NSW, Australia. · University of Texas, M.D. Anderson Cancer Centre, Houston, TX, USA. · The University of Sydney, Camperdown, NSW, Australia. · Melanoma Institute Australia, Wollstonecraft, NSW, Australia. · Royal North Shore Hospital, St Leonards, NSW, Australia. mustafa.khasraw@sydney.edu.au. · The University of Sydney, Camperdown, NSW, Australia. mustafa.khasraw@sydney.edu.au. · National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia. mustafa.khasraw@sydney.edu.au. ·Curr Oncol Rep · Pubmed #28417311.

ABSTRACT: PURPOSE OF REVIEW: Metastasis of cancer to the brain typically portends a poor prognosis and often results in significant morbidity, including from the side effects of treatment. More effective therapies for patients with brain metastases are needed. The current treatment paradigm uses multiple modalities, including surgery, radiation, and in some contexts, systemic chemotherapy and immunotherapy. Immune checkpoint inhibitors are increasingly being used to treat extracranial disease, and their effectiveness in the management of brain metastases needs to be understood. RECENT FINDINGS: The evidence for immune checkpoint inhibitors in the management of brain metastases is largely limited to retrospective analyses of melanoma metastases and ipilimumab. Prospective clinical trials of more active agents are under way, and tentative results suggest activity. Immune checkpoint inhibitors have the potential to improve outcomes in patients with brain metastases. Results of current clinical trials will aid in determining the appropriate sequence or combination of local and systemic therapies.

23 Review Targeted agents and immunotherapies: optimizing outcomes in melanoma. 2017

Luke, Jason J / Flaherty, Keith T / Ribas, Antoni / Long, Georgina V. ·Department of Medicine, Division of Hematology/Oncology, University of Chicago Comprehensive Cancer Center, 5841 South Maryland Avenue MC2115, Chicago, Illinois 60637, USA. · Department of Medicine, Harvard Medical School, Massachusetts General Hospital Cancer Center, 55 Fruit Street, Boston, Massachusetts 02114, USA. · Department of Medicine, Division of Hematology/Oncology, University of California Los Angeles Jonsson Comprehensive Cancer Center, 10833 Le Conte Avenue, Los Angeles, California 90024, USA. · Melanoma Institute Australia, The University of Sydney, and The Mater Hospital, Rocklands Road, North Sydney, New South Wales 2060, Australia. · Royal North Shore Hospital, Reserve Road, St Leonards, New South Wales 2065, Australia. ·Nat Rev Clin Oncol · Pubmed #28374786.

ABSTRACT: Treatment options for patients with metastatic melanoma, and especially BRAF-mutant melanoma, have changed dramatically in the past 5 years, with the FDA approval of eight new therapeutic agents. During this period, the treatment paradigm for BRAF-mutant disease has evolved rapidly: the standard-of-care BRAF-targeted approach has shifted from single-agent BRAF inhibition to combination therapy with a BRAF and a MEK inhibitor. Concurrently, immunotherapy has transitioned from cytokine-based treatment to antibody-mediated blockade of the cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) and, now, the programmed cell-death protein 1 (PD-1) immune checkpoints. These changes in the treatment landscape have dramatically improved patient outcomes, with the median overall survival of patients with advanced-stage melanoma increasing from approximately 9 months before 2011 to at least 2 years - and probably longer for those with BRAF-V600-mutant disease. Herein, we review the clinical trial data that established the standard-of-care treatment approaches for advanced-stage melanoma. Mechanisms of resistance and biomarkers of response to BRAF-targeted treatments and immunotherapies are discussed, and the contrasting clinical benefits and limitations of these therapies are explored. We summarize the state of the field and outline a rational approach to frontline-treatment selection for each individual patient with BRAF-mutant melanoma.

24 Review Nicotinamide for skin cancer chemoprevention. 2017

Damian, Diona L. ·Discipline of Dermatology, Central Clinical School, University of Sydney at Royal Prince Alfred Hospital and Melanoma Institute Australia, Sydney, Australia. ·Australas J Dermatol · Pubmed #28321860.

ABSTRACT: Nicotinamide (vitamin B

25 Review Immune checkpoint inhibitors in challenging populations. 2017

Johnson, Douglas B / Sullivan, Ryan J / Menzies, Alexander M. ·Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. · Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. · Department of Medicine, Melanoma Institute Australia, University of Sydney Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia. ·Cancer · Pubmed #28241095.

ABSTRACT: Immune checkpoint inhibitors, including those targeting the programmed cell death 1/programmed cell death ligand 1 and cytotoxic T lymphocyte antigen 4 pathways, are revolutionizing cancer therapeutics. Both activity and toxicities largely stem from unleashing tumor- or host-specific cytotoxic T cells. Many patients seen in routine clinical practice have not qualified for or have been seriously underrepresented in immune checkpoint inhibitor clinical trials. Thus, a major gap in knowledge regarding the safety and efficacy of these agents persists in many populations, even after regulatory approval. To address this challenge, this review aggregates and synthesizes the available preclinical and clinical data surrounding immune checkpoint inhibitor therapy in challenging clinical populations to assist both academic and community oncologists in treatment decision making. Specifically, this review focuses on the safety and activity of immune checkpoint inhibitors in patients with autoimmune disorders, organ transplant patients, patients with chronic viral infections, patients with ongoing immunosuppressant use, patients with organ dysfunction, pregnant patients, patients with brain metastases, patients at extremes of age, and patients with an impaired functional status. Cancer 2017;123:1904-1911. © 2017 American Cancer Society.

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