title: [Management of patients with metastatic cutaneous melanoma: French national guidelines. French National Cancer Institute].
abstract: BACKGROUND
  Recent years have seen the emergence of new molecules for the treatment of patients with metastatic cutaneous melanoma, with significant benefits in terms of survival and the opening of new therapeutic perspectives. In addition, many techniques are currently being developed for locoregional treatment of metastatic sites. Management of metastatic melanoma is thus fast-changing and is marked by innovative therapeutic approaches. However, the availability of these new treatments has prompted debate among healthcare professionals concerning their use and their place in therapeutic strategy.
  
  
  OBJECTIVE
  Since 2008, the French National Cancer Institute (INCa) has been leading a project to define and diffuse national clinical practice guidelines. It has performed a review of these treatment methods, which it aims to circulate, and it is seeking to develop recommendations in order to allow nationwide implementation of innovative approaches while promoting good use thereof.
  
  
  METHODS
  The clinical practice guidelines development process is based on systematic literature review and critical appraisal by experts within a multidisciplinary working group, with feedback from specialists in cancer care delivery. The recommendations are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines are reviewed by independent practitioners in cancer care delivery.
  
  
  RESULTS
  This article presents the national recommendations for first- and second-line systemic treatment and for locoregional treatment of metastatic sites in patients presenting metastatic cutaneous melanoma.
authors: Pôle pluridisciplinaire de médecine, clinique de dermatolo-vénéréologie, photobiologie et allergologie, hôpital Michallon, 38043 Grenoble, France.
authors: M-T
authors: MT
authors: Leccia
authors: Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. Electronic address: recommandations@institutcancer.fr.
authors: F
authors: F
authors: Planchamp
authors: Service de dermatologie, hôpital Cavale Blanche, boulevard Tanguy-Prigent, 29609 Brest, France.
authors: B
authors: B
authors: Sassolas
authors: Unité onco-dermatologie, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
authors: P
authors: P
authors: Combemale
authors: Service de dermatologie, hôpital Saint-Vincent-de-Paul, boulevard de Belfort, BP 387, 59020 Lille, France.
authors: P
authors: P
authors: Modiano
authors: Service de dermatologie, hôpital Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France.
authors: C
authors: C
authors: Bedane
authors: Service d'oncologie médicale, ICM, institut du cancer de Montpellier Val-d'Aurelle, parc Euromédecine, 208, avenue des Apothicaires, 34298 Montpellier, France.
authors: D
authors: D
authors: Cupissol
authors: Département de neurochirurgie, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France.
authors: S
authors: S
authors: Derrey
authors: Service de médecine nucléaire, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France.
authors: I
authors: I
authors: Dygai-Cochet
authors: Service d'anatomie pathologique, hôpital Purpan, place Baylac, 31059 Toulouse, France.
authors: L
authors: L
authors: Lamant
authors: Service de neurochirurgie, hôpital de Rangueil, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse, France.
authors: V
authors: V
authors: Lubrano
authors: Département de radiothérapie-curiethérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille, France.
authors: X
authors: X
authors: Mirabel
authors: Service de chirurgie oncologique, ICM, institut du cancer de Montpellier Val-d'Aurelle, parc Euromédecine, 208, avenue des Apothicaires, 34298 Montpellier, France.
authors: A
authors: A
authors: Mourrégot
authors: Cabinet médical, 59, rue de la Providence, 31500 Toulouse, France.
authors: M-E
authors: ME
authors: Rougé Bugat
authors: Cabinet médical, 3, rue Saint-Sigisbert, 57050 Le Ban-Saint-Martin, France.
authors: S
authors: S
authors: Siegrist
authors: Pôle de radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France.
authors: J
authors: J
authors: Thariat
authors: Service de chirurgie générale et thoracique, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne, France.
authors: O
authors: O
authors: Tiffet
authors: Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France.
authors: G
authors: G
authors: Truc
authors: Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France.
authors: L
authors: L
authors: Verdoni
authors: Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France.
authors: V
authors: V
authors: Mazeau-Woynar
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000601:surgery; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019468:Disease Management; D005602:France; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D000074324:Ipilimumab; D008113:Liver Neoplasms / Q000188:drug therapy / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery; D008545:Melanoma / Q000453:epidemiology / Q000235:genetics / Q000556:secondary* / Q000628:therapy*; D058990:Molecular Targeted Therapy; D009367:Neoplasm Staging; D009607:Nitrosourea Compounds / Q000627:therapeutic use; D009857:Oncogenes; D009943:Organophosphorus Compounds / Q000627:therapeutic use; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D012878:Skin Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000556:secondary* / Q000628:therapy; D013449:Sulfonamides / Q000627:therapeutic use; D000077204:Temozolomide; D000077484:Vemurafenib
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D007211:Indoles; D000074324:Ipilimumab; D009607:Nitrosourea Compounds; D009943:Organophosphorus Compounds; D013449:Sulfonamides; D000077484:Vemurafenib; D003606:Dacarbazine; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; C054368:fotemustine; D000077204:Temozolomide
keywords: Chemotherapy; Chimiothérapie; Clinical practice guidelines; Metastatic cutaneous melanoma; Mélanome cutané métastatique; Recommandations pour la pratique clinique; Targeted therapies; Thérapies ciblées; Traitement; Treatment