title: Advances in adjuvant therapy: potential for prognostic and predictive biomarkers.
abstract: Melanoma is the third most common skin cancer but accounts for the majority of skin cancer-related mortality. The rapidly rising incidence and younger age at diagnosis has made melanoma a leading cause of lost productive years of life and has increased the urgency of finding improved adjuvant therapy for melanoma. Interferon-α was approved for the adjuvant treatment of resected high-risk melanoma following studies that demonstrated improvements in relapse-free survival and overall survival that were commenced nearly 30 years ago. The clinical benefits associated with this agent have been consistently observed across multiple studies and meta-analyses in terms of relapse rate, and to a smaller and less-consistent degree, mortality. However, significant toxicity and lack of prognostic and/or predictive biomarkers that would allow greater risk-benefit ratio have limited the more widespread adoption of this modality.Recent success with targeted agents directed against components of the MAP-kinase pathway and checkpoint inhibitors have transformed the treatment landscape in metastatic disease. Current research efforts are centered around discovering predictive/prognostic biomarkers and exploring the options for more effective regimens, either singly or in combination.
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Diwakar
authors.initials: D
authors.lastname: Davar
authors.forename: Ahmad A
authors.initials: AA
authors.lastname: Tarhini
authors.forename: Helen
authors.initials: H
authors.lastname: Gogas
authors.forename: John M
authors.initials: JM
authors.lastname: Kirkwood
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D017024:Chemotherapy, Adjuvant / Q000639:trends; D006801:Humans; D008545:Melanoma / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D012878:Skin Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor