Current topics in melanoma.
OBJECTIVE
New approaches to melanoma are emerging. This review summarizes developments over the past 12 months.


RESULTS
Surgical, chemotherapeutic, immunologic and targeted therapies for melanoma are evolving. Sentinel lymph node sampling is now accepted as the standard of care for patients with intermediate thickness primary melanomas. Temozolomide continues to be widely used as part of combination therapy, and recent evidence suggests that a combination of temozolomide and interferon-alpha may be superior to temozolomide alone. Meanwhile, temozolomide and thalidomide carries unacceptable thrombosis risk. In the area of immunotherapy, anti-CTLA-4 continues to show promise, but special attention must be paid to gastrointestinal toxicity. Interferon-alpha, in addition, has shown efficacy in the neoadjuvant setting with inflammatory infiltrates demonstrated in tumors. A better understanding of the complex genetic regulation of melanoma cell growth is emerging and this is expected to lead to the development of novel targeted therapies.


CONCLUSIONS
Research is producing a more complete understanding of melanoma genetics and immune regulation. These are beginning to produce therapeutics that are impacting clinical practice.
Wolchok
Jedd D
JD
Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. wolchokj@mskcc.org
Saenger
Yvonne M
YM
D000069594:Abatacept; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy; D008545:Melanoma / Q000473:pathology / Q000628:therapy*; D021701:Sentinel Lymph Node Biopsy
D000970:Antineoplastic Agents; D018796:Immunoconjugates; D007166:Immunosuppressive Agents; D000069594:Abatacept