The Benefits and Challenges of the Multimodal Treatment in Advanced/Metastatic Malignant Melanoma
Currently, the treatment of malignant melanoma offers the longest and the most studied experience of innovative treatments in malignant pathology. The algorithm of the therapeutic decision in advanced or metastatic melanoma must comprise: the timing of the therapeutic initiation, the sequencing of t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/9/1635 |
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| author | Alexandru-Rares Stoian Gabriela Rahnea-Nita Anda-Natalia Ciuhu Laurentia Gales Rodica-Maricela Anghel Laura-Florentina Rebegea Roxana-Andreea Rahnea-Nita Liliana-Florina Andronache Ioana Soare Gabriela Stoleriu |
| author_facet | Alexandru-Rares Stoian Gabriela Rahnea-Nita Anda-Natalia Ciuhu Laurentia Gales Rodica-Maricela Anghel Laura-Florentina Rebegea Roxana-Andreea Rahnea-Nita Liliana-Florina Andronache Ioana Soare Gabriela Stoleriu |
| author_sort | Alexandru-Rares Stoian |
| collection | DOAJ |
| description | Currently, the treatment of malignant melanoma offers the longest and the most studied experience of innovative treatments in malignant pathology. The algorithm of the therapeutic decision in advanced or metastatic melanoma must comprise: the timing of the therapeutic initiation, the sequencing of the specific oncological treatment (radiotherapy and chemotherapy still being therapeutic alternatives in selected cases), the diagnosis and the management of adverse reactions. We present the case of a patient diagnosed with metastatic malignant melanoma in November 2019, who progressed successively under new systemic treatment throughout the 3 years of treatment and experienced skin reactions of various degrees of severity. The comprehensive response to secondary hilar pulmonary lymphatic determinations under subsequent chemotherapy was specific to the presented case. The occurrence of vitiligo secondary to immunotherapy is a favorable prognostic factor, but the occurrence of secondary cerebral determinations is an extremely severe prognostic factor in malignant melanoma and a challenge in making the therapeutic decision. Previous treatment with immune checkpoint inhibitors may trigger a favorable response to systemic chemotherapy. The early and accurate diagnosis of the adverse events of the new therapies requires a multidisciplinary approach, because it can radically change the therapeutic decision. |
| first_indexed | 2024-03-11T04:21:02Z |
| format | Article |
| id | doaj.art-4b20f838a46c4e67ba501d2e33d64b3d |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T04:21:02Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-4b20f838a46c4e67ba501d2e33d64b3d2023-11-17T22:46:21ZengMDPI AGDiagnostics2075-44182023-05-01139163510.3390/diagnostics13091635The Benefits and Challenges of the Multimodal Treatment in Advanced/Metastatic Malignant MelanomaAlexandru-Rares Stoian0Gabriela Rahnea-Nita1Anda-Natalia Ciuhu2Laurentia Gales3Rodica-Maricela Anghel4Laura-Florentina Rebegea5Roxana-Andreea Rahnea-Nita6Liliana-Florina Andronache7Ioana Soare8Gabriela Stoleriu9Clinical Department, Faculty of Medicine, The University of Medicine and Pharmacy “Carol Davila”, 8 Eroii Sanitari Street, 050474 Bucharest, RomaniaClinical Department, Faculty of Medicine, The University of Medicine and Pharmacy “Carol Davila”, 8 Eroii Sanitari Street, 050474 Bucharest, Romania“Sf. Luca” Chronic Disease Hospital, 041915 Bucharest, RomaniaClinical Department, Faculty of Medicine, The University of Medicine and Pharmacy “Carol Davila”, 8 Eroii Sanitari Street, 050474 Bucharest, RomaniaClinical Department, Faculty of Medicine, The University of Medicine and Pharmacy “Carol Davila”, 8 Eroii Sanitari Street, 050474 Bucharest, RomaniaRadiotherapy Department, “Sf. Ap. Andrei” County Emergency Clinical Hospital, 800579 Galati, RomaniaClinical Department, Faculty of Medicine, The University of Medicine and Pharmacy “Carol Davila”, 8 Eroii Sanitari Street, 050474 Bucharest, RomaniaClinical Department, Faculty of Medicine, The University of Medicine and Pharmacy “Carol Davila”, 8 Eroii Sanitari Street, 050474 Bucharest, RomaniaClinical Department, The Faculty of Medicine, “Titu Maiorescu” University, 040051 Bucharest, RomaniaClinical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, RomaniaCurrently, the treatment of malignant melanoma offers the longest and the most studied experience of innovative treatments in malignant pathology. The algorithm of the therapeutic decision in advanced or metastatic melanoma must comprise: the timing of the therapeutic initiation, the sequencing of the specific oncological treatment (radiotherapy and chemotherapy still being therapeutic alternatives in selected cases), the diagnosis and the management of adverse reactions. We present the case of a patient diagnosed with metastatic malignant melanoma in November 2019, who progressed successively under new systemic treatment throughout the 3 years of treatment and experienced skin reactions of various degrees of severity. The comprehensive response to secondary hilar pulmonary lymphatic determinations under subsequent chemotherapy was specific to the presented case. The occurrence of vitiligo secondary to immunotherapy is a favorable prognostic factor, but the occurrence of secondary cerebral determinations is an extremely severe prognostic factor in malignant melanoma and a challenge in making the therapeutic decision. Previous treatment with immune checkpoint inhibitors may trigger a favorable response to systemic chemotherapy. The early and accurate diagnosis of the adverse events of the new therapies requires a multidisciplinary approach, because it can radically change the therapeutic decision.https://www.mdpi.com/2075-4418/13/9/1635malignant melanomanew therapeutic approachchemotherapyadverse events |
| spellingShingle | Alexandru-Rares Stoian Gabriela Rahnea-Nita Anda-Natalia Ciuhu Laurentia Gales Rodica-Maricela Anghel Laura-Florentina Rebegea Roxana-Andreea Rahnea-Nita Liliana-Florina Andronache Ioana Soare Gabriela Stoleriu The Benefits and Challenges of the Multimodal Treatment in Advanced/Metastatic Malignant Melanoma Diagnostics malignant melanoma new therapeutic approach chemotherapy adverse events |
| title | The Benefits and Challenges of the Multimodal Treatment in Advanced/Metastatic Malignant Melanoma |
| title_full | The Benefits and Challenges of the Multimodal Treatment in Advanced/Metastatic Malignant Melanoma |
| title_fullStr | The Benefits and Challenges of the Multimodal Treatment in Advanced/Metastatic Malignant Melanoma |
| title_full_unstemmed | The Benefits and Challenges of the Multimodal Treatment in Advanced/Metastatic Malignant Melanoma |
| title_short | The Benefits and Challenges of the Multimodal Treatment in Advanced/Metastatic Malignant Melanoma |
| title_sort | benefits and challenges of the multimodal treatment in advanced metastatic malignant melanoma |
| topic | malignant melanoma new therapeutic approach chemotherapy adverse events |
| url | https://www.mdpi.com/2075-4418/13/9/1635 |
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