[What's new in oncodermatology?].
Several epidemiologic studies using the Surveillance, Epidemiology and End results program, have shown that the incidence of melanoma and of cutaneous lymphomas has clearly increased in the United States. Two independent groups have reported genome-wide association studies identifying variants associated to an increased risk of melanoma. Tumor stem cells were found to have an increased frequency when compared to previously reported studies, and also a greater plasticity. The Merkel cell polyoma virus seems rather ubiquitous, since it has been evidenced, without clonal integration, in several other types of cutaneous tumors, and even in healthy skin, with an increased frequency in photo-exposed skin and in immunodepressed patients. A recent study demonstrates for the first time a link between the exposure to pesticides and the occurrence of lymphomas. Another study has evidenced the association between topical treatments with steroids and the occurrence of lymphomas, especially cutaneous lymphomas. The risk is increased with the length of treatment and the potency of steroids. Adjuvant treatment of high-risk melanomas with alpha interferon does not achieve better results with the adjunction of a 4 weeks high-dose induction period, and development of autoantibodies is not significantly associated to an increased relapse free survival after correction of the time related biais. In contrast, the effect of interferon on relapse free survival, distant metastasis free survival and overall survival seems better in the subgroup of melanoma with primary ulceration. The development of new specific inhibitors of c-kit or BRAF is a great hope for the targeted treatment of peculiar groups of advanced melanomas. The main objectives of the new 2009-2013 Cancer Plan is to optimize the structuration of health organization in the field of oncology.
Bagot
M
M
Service de Dermatologie, Centre de Cancérologie Cutanée et Centre de Recherche sur la Peau, Hôpital Saint Louis, Paris, France. martine.bagot@sls.aphp.fr
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D002280:Basal Cell Carcinoma; D015266:Carcinoma, Merkel Cell; D003880:Dermatology / Q000639:trends*; D019317:Evidence-Based Medicine; D005602:France / Q000453:epidemiology; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D015994:Incidence; D016898:Interferon-alpha / Q000008:administration & dosage; D008223:Lymphoma / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D016393:Lymphoma, B-Cell; D016410:Lymphoma, T-Cell, Cutaneous; D008545:Melanoma / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D010575:Pesticides / Q000009:adverse effects; D011379:Prognosis; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors; D012307:Risk Factors; D018426:SEER Program; D012878:Skin Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D014481:United States / Q000453:epidemiology
D005938:Glucocorticoids; D007155:Immunologic Factors; D016898:Interferon-alpha; D010575:Pesticides; D048493:Proto-Oncogene Proteins B-raf