Malignant melanoma: current state of primary and adjuvant treatment. 2003

Timothy M Pawlik, and Vernon K Sondak
Division of Surgical Oncology, University of Michigan Medical School, Ann Arbor, MI 48109-0031, USA.

Metastatic malignant melanoma remains a highly lethal disease with an incidence that continues to rise. Management of melanoma includes definitive local, regional and distant control. There is substantial prospective and retrospective data to base the extent of both primary as well as adjuvant therapy. The results of these trials have on occasion been at odds. A critical assessment of the available information pertaining to the adjuvant treatment of cutaneous melanoma is needed. This review provides a critical assessment of the current data that is available to guide both primary resection as well as adjuvant therapy. To date, current trials have shown little promise with nonspecific immunostimulants and cytotoxic chemotherapy. In contrast, dose interferon-alpha2b has been shown to improve relapse-free survival and likely improves melanoma-specific survival as well. Based on the available data, interferon-alpha2b remains the adjuvant therapy of choice for high-risk patients treated outside clinical trials, and the appropriate control arm for clinical trials evaluating new or modified adjuvant regimens.

UI MeSH Term Description Entries
D008207 Lymphatic Metastasis Transfer of a neoplasm from its primary site to lymph nodes or to distant parts of the body by way of the lymphatic system. Lymph Node Metastasis,Lymph Node Metastases,Lymphatic Metastases,Metastasis, Lymph Node
D008545 Melanoma A malignant neoplasm derived from cells that are capable of forming melanin, which may occur in the skin of any part of the body, in the eye, or, rarely, in the mucous membranes of the genitalia, anus, oral cavity, or other sites. It occurs mostly in adults and may originate de novo or from a pigmented nevus or malignant lentigo. Melanomas frequently metastasize widely, and the regional lymph nodes, liver, lungs, and brain are likely to be involved. The incidence of malignant skin melanomas is rising rapidly in all parts of the world. (Stedman, 25th ed; from Rook et al., Textbook of Dermatology, 4th ed, p2445) Malignant Melanoma,Malignant Melanomas,Melanoma, Malignant,Melanomas,Melanomas, Malignant
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016898 Interferon-alpha One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells. In addition to antiviral activity, it activates NATURAL KILLER CELLS and B-LYMPHOCYTES, and down-regulates VASCULAR ENDOTHELIAL GROWTH FACTOR expression through PI-3 KINASE and MAPK KINASES signaling pathways. Interferon Alfa,Interferon, Leukocyte,Interferon, Lymphoblast,alpha-Interferon,IFN-alpha D,IFN-alpha5,Interferon alpha-1,Interferon alpha-17,Interferon alpha-4,Interferon alpha-5,Interferon alpha-7,Interferon alpha-88,Interferon alpha-J,Interferon alpha-T,Interferon alpha4,Interferon alpha5,Interferon, Lymphoblastoid,Interferon, alpha,LeIF I,LeIF J,Leif D,IFN alpha D,IFN alpha5,Interferon alpha,Interferon alpha 1,Interferon alpha 17,Interferon alpha 4,Interferon alpha 5,Interferon alpha 7,Interferon alpha 88,Interferon alpha J,Interferon alpha T,Leukocyte Interferon,Lymphoblast Interferon,Lymphoblastoid Interferon,alpha Interferon
D017024 Chemotherapy, Adjuvant Drug therapy given to augment or stimulate some other form of treatment such as surgery or radiation therapy. Adjuvant chemotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment. Adjuvant Chemotherapy,Drug Therapy, Adjuvant,Adjuvant Drug Therapy
D018714 Radiotherapy, Adjuvant Radiotherapy given to augment some other form of treatment such as surgery or chemotherapy. Adjuvant radiotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment. Adjuvant Radiotherapy,Adjuvant Radiotherapies,Radiotherapies, Adjuvant
D019496 Cancer Vaccines Vaccines or candidate vaccines designed to prevent or treat cancer. Vaccines are produced using the patient's own whole tumor cells as the source of antigens, or using tumor-specific antigens, often recombinantly produced. Cancer Vaccine,Neoplasm Vaccines,Tumor Vaccine,Tumor Vaccines,Vaccines, Cancer,Vaccines, Neoplasm,Vaccines, Tumor,Vaccine, Cancer,Vaccine, Tumor

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