Diagnosis and Treatment of Cutaneous Melanoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (20 November 2024) | Viewed by 4501

Special Issue Editors


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Guest Editor
Division of Pathology, Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politec-Nica delle Marche, Azienda Ospedaliero Universitaria delle Marche, Via Conca 71, 60126 Ancona, Italy
Interests: melanoma; non melanoma skin cancer; Inflammatory dermatoses; molecular biology of cancer; cutaneous lymphoma; clinico-pathological correlation

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Guest Editor
Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
Interests: dermatological diagnosis; venereal disease diagnosis; skin disorders; sexually transmitted infections (STIs); clinical manifestations; diagnostic methods
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Special Issue Information

Dear Colleagues,

Cutaneous melanoma accounts for almost 90% of skin cancer mortality cases. Complete excisional biopsy is mandatory to achieve accurate tumour microstaging that is essential for stratifying the patients’ prognosis and future management, both surgically and with adjuvant medical and immunological therapies. The recent advances in therapeutic options for patients with advanced melanoma have stressed, once again, the importance of accurate staging and early management. In particular, the oncological approach of patients with Stage III disease has changed in recent years. Surgery is recommended less often, and patients may receive potentially life-prolonging systemic therapies. Multidisciplinary discussions on management are recommended, and molecular biology represents an essential tool to integrate the clinico-pathological diagnosis of melanoma.

Dr. Alessandra Filosa
Dr. Francesca Ambrogio
Guest Editors

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Keywords

  • melanoma diagnosis
  • molecular pathways
  • immunotherapy
  • prognostic molecular stratification

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Published Papers (3 papers)

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Research

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14 pages, 1438 KiB  
Article
Adjuvant Immunotherapy After Resected Melanoma: Survival Outcomes, Prognostic Factors and Patterns of Relapse
by Sergio Martinez-Recio, Maria Alejandra Molina-Pérez, Eva Muñoz-Couselo, Alberto R. Sevillano-Tripero, Francisco Aya, Ana Arance, Mayra Orrillo, Juan Martin-Liberal, Luis Fernandez-Morales, Rocio Lesta, María Quindós-Varela, Maria Nieva, Joana Vidal, Daniel Martinez-Perez, Andrés Barba and Margarita Majem
Cancers 2025, 17(1), 143; https://doi.org/10.3390/cancers17010143 - 5 Jan 2025
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Abstract
Background: Anti-PD-1-based immunotherapy has improved outcomes in stage IIB to IV resected melanoma patients in clinical trials. However, little is known about real-world outcomes, prognostic factors and patterns of relapse. Methods: This is a retrospective multicenter observational study including patients with resected melanoma [...] Read more.
Background: Anti-PD-1-based immunotherapy has improved outcomes in stage IIB to IV resected melanoma patients in clinical trials. However, little is known about real-world outcomes, prognostic factors and patterns of relapse. Methods: This is a retrospective multicenter observational study including patients with resected melanoma treated with subsequent anti-PD-1-based adjuvant immunotherapy. Data on clinical and demographic characteristics, delivered treatment, prognostic factors, time and pattern of relapse were collected. Results: We included 245 patients from eight centers; 4% of patients were at stage IIB-C, 80% at stage IIIA-D and 16% at stage IV. Recurrence-free survival (RFS) rates at 18 and 36 months were 60% and 48%, respectively, with a median RFS of 33.7 months. Prognostic factors associated with recurrence were melanoma primary site (HR 2.64, 95% CI 1.15–6.01) and starting adjuvant therapy more than 12 weeks after the last resection (HR 1.68, 95% CI 1.13–2.5); presence of serious immune-related adverse events was associated with better RFS (HR 0.4, 95% CI 0.19–0.87). Early relapses accounted for 63% of the total recurrences, with a higher number of metastatic sites (18%); in contrast, late relapses presented more frequently with brain metastases (20%). Conclusions: In our patients with resected melanoma who underwent anti-PD-1-based adjuvant immunotherapy, survival outcomes were worse than those reported in clinical trials. Primary melanoma site and time interval between the last resection and the start of adjuvant therapy were associated with survival. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Cutaneous Melanoma)
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16 pages, 4389 KiB  
Article
Cutaneous Nevoid Melanoma: A Retrospective Study on Clinico-Pathological Characteristics, with a Focus on Dermoscopic Features and Survival Analysis
by Irene Russo, Emma Sartor, Rocco Cappellesso, Roberto Salmaso, Paolo Del Fiore, Gino Sartor, Antonella Vecchiato, Mauro Alaibac and Simone Mocellin
Cancers 2025, 17(1), 65; https://doi.org/10.3390/cancers17010065 - 29 Dec 2024
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Abstract
Background: Diagnosis of nevoid melanoma (NeM) is often difficult because NeM closely resembles a common nevus clinically and histologically. Methods: A retrospective study was conducted on 110 patients diagnosed with and/or treated for primary nevoid melanoma at the Veneto Institute of Oncology and [...] Read more.
Background: Diagnosis of nevoid melanoma (NeM) is often difficult because NeM closely resembles a common nevus clinically and histologically. Methods: A retrospective study was conducted on 110 patients diagnosed with and/or treated for primary nevoid melanoma at the Veneto Institute of Oncology and at the University Hospital of Padua from August 1999. Results: Mean Breslow thickness was of 1.4 mm. Sentinel lymph node biopsy was conducted in nearly half of the patients, and positivity was detected in 16.7% of them. Twenty-four clinical and 23 dermoscopic pictures were collected. Papular and macular lesions prevailed over nodular and plaque-type lesions. Different hues of brown, pink, and red color were most represented. Twenty nevus-like NeMs and four multicomponent-pattern NeMs were observed. The Most frequent dermoscopic patterns for nevus-like NeM were atypical pigmented reticulum, irregular globules and dots, and hyperpigmented blotches. Atypical vessels, asymmetric peripheric striae, blue-white veil, and areas of regression were less frequent and prevailed in multicomponent pattern NeM. A structureless pattern was also featured. Many patients in the series had multiple melanomas. However, none of them had numerous multiple nevoid melanomas. Conclusions: NeM should not be regarded as a separate biological entity from classical melanoma, and the same histological and clinical prognostic factors apply to NeM. Clinically and dermoscopically, it often resembles benign nevi, although some clues such as evolution and some dermoscopic patterns could suggest malignancy. Clinical suspicion might prove crucial to further pathological analysis and recognition. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Cutaneous Melanoma)
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Review

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12 pages, 291 KiB  
Review
Epigenetics and Control of Tumor Angiogenesis in Melanoma: An Update with Therapeutic Implications
by Gerardo Cazzato, Nicoletta Sgarro, Nadia Casatta, Carmelo Lupo, Giuseppe Ingravallo and Domenico Ribatti
Cancers 2024, 16(16), 2843; https://doi.org/10.3390/cancers16162843 - 14 Aug 2024
Cited by 3 | Viewed by 1775
Abstract
Angiogenesis, the formation of new blood vessels from pre-existing ones, is a crucial process in the progression and metastasis of melanoma. Recent research has highlighted the significant role of epigenetic modifications in regulating angiogenesis. This review comprehensively examines the current understanding of how [...] Read more.
Angiogenesis, the formation of new blood vessels from pre-existing ones, is a crucial process in the progression and metastasis of melanoma. Recent research has highlighted the significant role of epigenetic modifications in regulating angiogenesis. This review comprehensively examines the current understanding of how epigenetic mechanisms, including DNA methylation, histone modifications, and non-coding RNAs, influence angiogenic pathways in melanoma. DNA methylation, a key epigenetic modification, can silence angiogenesis inhibitors such as thrombospondin-1 and TIMP3 while promoting pro-angiogenic factors like vascular endothelial growth factor (VEGF). Histone modifications, including methylation and acetylation, also play a pivotal role in regulating the expression of angiogenesis-related genes. For instance, the acetylation of histones H3 and H4 is associated with the upregulation of pro-angiogenic genes, whereas histone methylation patterns can either enhance or repress angiogenic signals, depending on the specific histone mark and context. Non-coding RNAs, particularly microRNAs (miRNAs) further modulate angiogenesis. miRNAs, such as miR-210, have been identified as key regulators, with miR-9 promoting angiogenesis by targeting E-cadherin and enhancing the expression of VEGF. This review also discusses the therapeutic potential of targeting epigenetic modifications to inhibit angiogenesis in melanoma. Epigenetic drugs, such as DNA methyltransferase inhibitors (e.g., 5-azacytidine) and histone deacetylase inhibitors (e.g., Vorinostat), have shown promise in preclinical models by reactivating angiogenesis inhibitors and downregulating pro-angiogenic factors. Moreover, the modulation of miRNAs and lncRNAs presents a novel approach for anti-angiogenic therapy. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Cutaneous Melanoma)
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