Risultati per: Immunoterapia cellulare promettente contro il melanoma

Ascierto, il 50% dei pazienti metastatici sopravvive a 10 anni dalla diagnosi

New England Journal of Medicine, Volume 392, Issue 1, Page 81-82, January 2, 2025.

Introduction
A diagnosis of melanoma in situ presents negligible risk to a person’s lifespan or physical well-being, but existing terminology makes it difficult for patients to distinguish these from higher risk invasive melanomas. This study aims to explore whether using an alternative label for melanoma in situ may influence patients’ management choices and anxiety levels.

Methods and analysis
This study is a between-subjects randomised online experiment, using hypothetical scenarios. Following consent, eligible participants will be randomised 1:1:1 to three labels: ‘melanoma in situ’ (control), ‘low-risk melanocytic neoplasm’ (intervention 1) and ‘low-risk melanocytic neoplasm, in situ’ (intervention 2). The required sample size is 1668 people. The co-primary outcomes are (1) choice between no further surgery or further surgery to ensure clear histological margins greater than 5 mm and (2) choice between patient-initiated clinical follow-up when needed (patient-led surveillance) and regular routinely scheduled clinical follow-up (clinician-led surveillance). Secondary outcomes include diagnosis anxiety, perceived risk of invasive melanoma and of dying from melanoma and management choice anxiety (after surgery choice and follow-up choice). We will make pairwise comparisons across the three diagnostic label groups using regression models (univariable and multivariable).

Ethics and dissemination
The study has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12624000740594). Ethics approval has been received from The University of Sydney Human Research Ethics Committee (2024/HE000019). The results of the study will be published in a peer-reviewed medical journal, and a plain language summary of the findings will be shared on the Wiser Healthcare publication page (https://www.wiserhealthcare.org.au/category/publications/).

Trial registration number
Australian New Zealand Clinical Trials Registry (ID 386943).

Higher glucocorticoid doses and prednisone use in melanoma patients with SAI may be due to higher distress scores rather than SAI itself. Given the negative impact on survival and potential side effects, we recommend hydrocortisone at standard doses as the preferred glucocorticoid replacement in melanoma patients with SAI.

Ascierto, +25% di sopravvivenza in forme malattia avanzate

These results suggest that a one-year course of immunotherapy is both necessary and sufficient for patients with advanced melanoma. Prolonged treatment beyond 2 years does not appear to be beneficial in terms of survival and could even be detrimental.

Ascierto, ‘dai raggi solari ci si deve difendere anche in inverno’

Efficace nel 30% dei pazienti che non risponde alle altre cure

This cohort study assesses the incidence of a second melanoma diagnosis after initial diagnosis among racial and ethnic minority populations.

In Reply We appreciate the thoughtful comments to this Viewpoint by Karahan et al that emphasize the importance of considering additional predictive parameters when determining immunotherapy treatment strategies for patients with advanced melanoma. In patients with treatment-naive unresectable or metastatic melanoma and no central nervous system metastases, various clinical and molecular biomarkers, including programmed cell death ligand 1 (PD-L1) status (1% cut-off), liver metastases, BRAF mutational status, and the number of involved metastatic organs may help guide the shared decision-making process for dual checkpoint inhibition with ipilimumab plus nivolumab vs anti–programmed cell death 1 (PD-1) monotherapy. In addition, acknowledging the challenges in precisely defining this population in clinical trials and clinical studies, patients with rapidly progressing and/or symptomatic disease, very high tumor burden, or disease localization in organs at high risk (eg, close to critical anatomic structures like the spinal cord or upper airways) might obtain superior benefit from combination therapy with ipilimumab plus nivolumab due to the fast kinetics of response. To our knowledge, no defined biomarkers, other than PD-L1 at the 1% cut-off, exist for guiding the choice between the combination of relatlimab plus nivolumab and anti-PD-1 monotherapy.

To the Editor We read with great interest the comments by Donia and Prasad suggesting that for patients with tumors exhibiting positive staining (≥1%) for programmed cell death ligand 1 (PD-L1), nivolumab monotherapy offers maximal benefit while cautioning against the necessity of the combination therapy due to toxic effects and cost. However, we wish to address certain points and express our reservations regarding this stance.

This cohort study assesses incidence of primary invasive cutaneous malignant melanoma and mortality trends in Sweden, focusing on the population younger than the mean age of melanoma onset.

Tra gli effetti indesiderati le disfunzioni di tiroide e ipofisi