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Noncutaneous melanomas: a single-center analysis


Del Prete, Valerio; Chaloupka, Karla; Holzmann, David; Fink, Daniel; Levesque, Mitchell; Dummer, Reinhard; Goldinger, Simone M (2015). Noncutaneous melanomas: a single-center analysis. Dermatology, 232(1):22-29.

Abstract

Background: The optimal treatment algorithm for noncutaneous melanomas must yet be established. Objective: To compare systemic treatment-relevant mutational status, metastatic pattern and response to systemic treatment in noncutaneous melanoma. Methods: Retrospective single-center study analyzing 64 noncutaneous melanoma patients treated between January 2006 and September 2013. Results: c-KIT mutations were found exclusively in vulvovaginal melanoma (4/7). Overall status for NRAS and BRAF mutations was low (1/7 and 0/21 detected mutations, respectively). Seven out of 7 vulvovaginal and 6/13 sinonasal melanomas first metastasized to lymph nodes, whereas 18/22 ocular melanomas first metastasized to the liver. Response to systemic treatment in vulvovaginal melanomas was best for imatinib with a disease control rate of 3/3 and overall for ipilimumab with a disease control rate of 3/10. Sorafenib was associated with adverse drug reactions (6/13) and poor results. Conclusion: Noncutaneous melanomas show few tumor-signaling pathway mutations and distinct metastasization patterns. Immunotherapy induces response rates in mucosal melanoma similar to those in cutaneous melanoma.

Abstract

Background: The optimal treatment algorithm for noncutaneous melanomas must yet be established. Objective: To compare systemic treatment-relevant mutational status, metastatic pattern and response to systemic treatment in noncutaneous melanoma. Methods: Retrospective single-center study analyzing 64 noncutaneous melanoma patients treated between January 2006 and September 2013. Results: c-KIT mutations were found exclusively in vulvovaginal melanoma (4/7). Overall status for NRAS and BRAF mutations was low (1/7 and 0/21 detected mutations, respectively). Seven out of 7 vulvovaginal and 6/13 sinonasal melanomas first metastasized to lymph nodes, whereas 18/22 ocular melanomas first metastasized to the liver. Response to systemic treatment in vulvovaginal melanomas was best for imatinib with a disease control rate of 3/3 and overall for ipilimumab with a disease control rate of 3/10. Sorafenib was associated with adverse drug reactions (6/13) and poor results. Conclusion: Noncutaneous melanomas show few tumor-signaling pathway mutations and distinct metastasization patterns. Immunotherapy induces response rates in mucosal melanoma similar to those in cutaneous melanoma.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Ophthalmology Clinic
04 Faculty of Medicine > University Hospital Zurich > Clinic for Gynecology
04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:December 2015
Deposited On:09 Dec 2015 16:44
Last Modified:08 Dec 2017 15:25
Publisher:Karger
ISSN:1018-8665
Publisher DOI:https://doi.org/10.1159/000441444
PubMed ID:26618350

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