First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand?

Cutaneous melanoma has always been a dreaded diagnosis because of its high mortality rate and its proclivity for invasiveness and metastasis. Historically, advanced melanoma treatment has been limited to chemotherapy and nonspecific immunotherapy agents that display poor curative potentia...

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Main Authors: Louay S Abdulkarim, Richard J Motley
Format: Article
Language:English
Published: JMIR Publications 2021-12-01
Series:JMIR Cancer
Online Access:https://cancer.jmir.org/2021/4/e29912
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author Louay S Abdulkarim
Richard J Motley
author_facet Louay S Abdulkarim
Richard J Motley
author_sort Louay S Abdulkarim
collection DOAJ
description Cutaneous melanoma has always been a dreaded diagnosis because of its high mortality rate and its proclivity for invasiveness and metastasis. Historically, advanced melanoma treatment has been limited to chemotherapy and nonspecific immunotherapy agents that display poor curative potential and high toxicity. However, during the last decade, the evolving understanding of the mutational burden of melanoma and immune system evasion mechanisms has led to the development of targeted therapy and specific immunotherapy agents that have transformed the landscape of advanced melanoma treatment. Despite the considerable strides in understanding the clinical implications of these agents, there is a scarcity of randomized clinical trials that directly compare the efficacy of the aforementioned agents; hence, there are no clear preferences among the available first-line options. In addition, the introduction of these agents was associated with a variety of dermatologic adverse events, some of which have shown a detrimental effect on the continuity of treatment. This holds especially true in light of the current fragmentation of care provided by the managing health care professionals. In this study, we attempt to summarize the current understanding of first-line treatments. In addition, the paper describes the indirect comparative evidence that aids in bridging the gap in the literature. Furthermore, this paper sheds light on the impact of the scarcity of dermatology specialist input in the management of dermatologic adverse events associated with advanced melanoma treatment. It also looks into the potential avenues where dermatologic input can bridge the gap in the care provided by oncologists, thus standardizing the care provided to patients with melanoma presenting with dermatologic adverse events.
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spelling doaj.art-e174d020ca2f416c8e20fa9d283bdbf72023-08-28T20:01:14ZengJMIR PublicationsJMIR Cancer2369-19992021-12-0174e2991210.2196/29912First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand?Louay S Abdulkarimhttps://orcid.org/0000-0003-1968-1224Richard J Motleyhttps://orcid.org/0000-0003-2226-6961 Cutaneous melanoma has always been a dreaded diagnosis because of its high mortality rate and its proclivity for invasiveness and metastasis. Historically, advanced melanoma treatment has been limited to chemotherapy and nonspecific immunotherapy agents that display poor curative potential and high toxicity. However, during the last decade, the evolving understanding of the mutational burden of melanoma and immune system evasion mechanisms has led to the development of targeted therapy and specific immunotherapy agents that have transformed the landscape of advanced melanoma treatment. Despite the considerable strides in understanding the clinical implications of these agents, there is a scarcity of randomized clinical trials that directly compare the efficacy of the aforementioned agents; hence, there are no clear preferences among the available first-line options. In addition, the introduction of these agents was associated with a variety of dermatologic adverse events, some of which have shown a detrimental effect on the continuity of treatment. This holds especially true in light of the current fragmentation of care provided by the managing health care professionals. In this study, we attempt to summarize the current understanding of first-line treatments. In addition, the paper describes the indirect comparative evidence that aids in bridging the gap in the literature. Furthermore, this paper sheds light on the impact of the scarcity of dermatology specialist input in the management of dermatologic adverse events associated with advanced melanoma treatment. It also looks into the potential avenues where dermatologic input can bridge the gap in the care provided by oncologists, thus standardizing the care provided to patients with melanoma presenting with dermatologic adverse events.https://cancer.jmir.org/2021/4/e29912
spellingShingle Louay S Abdulkarim
Richard J Motley
First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand?
JMIR Cancer
title First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand?
title_full First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand?
title_fullStr First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand?
title_full_unstemmed First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand?
title_short First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand?
title_sort first line advanced cutaneous melanoma treatments where do we stand
url https://cancer.jmir.org/2021/4/e29912
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