Ok alla rimborsabilità negli stadi iniziali della malattia, può aumentare le guarigioni
Risultati per: Melanoma cutaneo
Questo è quello che abbiamo trovato per te
Nivolumab plus Ipilimumab in Advanced Melanoma
New England Journal of Medicine, Volume 392, Issue 12, Page 1245-1246, March 27, 2025.
Melanoma, il mix di 9 batteri migliora l'immunoterapia
Al Pascale trattato primo paziente di uno studio internazionale
Melanoma, il mix di 9 batteri migliora l'immunoterapia
Al Pascale trattato primo paziente di uno studio internazionale
Intracranial Outcomes in Melanoma Brain Metastases After Anti–PD-1 Therapy
This cohort study examines the response and survival rates associated with ipilimumab-nivolumab therapy in patients with progressive melanoma brain metastases after anti–programmed cell death 1 (anti–PD-1) therapy.
Al Cro di Aviano un nuovo studio sul melanoma cutaneo
Fatta luce sul ruolo della proteina Spry1
Melanoma Tumor Mutational Burden and Indoor Tanning Exposure
This cohort study evaluates the association between cutaneous melanoma tumor mutational burden and indoor tanning exposure, as well as other demographic, dermatologic, and tumor characteristics.
Risk of Death Due to Melanoma and Other Causes in Patients With Thin Cutaneous Melanomas
This cohort study examines the association between the risks of melanoma-associated death and nonmelanoma-associated death for each 0.1-mm increase in Breslow thickness from 0.1 mm to 1.0 mm in a large cohort of adults diagnosed with a first invasive primary melanoma of 1.0 mm or smaller in Australia.
Characterising melanoma diagnostic pathways for patients in routine practice using administrative health data in Ontario, Canada: a population-based study
Objective
To characterise diagnostic pathways for patients with melanoma in routine practice and compare patient, disease and diagnostic interval (DI) characteristics across pathways.
Design
Descriptive cross-sectional study using administrative health data.
Setting
Population-based study in Ontario, Canada.
Participants
Patients with melanoma diagnosed from 2007 to 2019.
Main outcome measures
We used latent class cluster analysis to create clusters of patients with similar diagnostic experiences to characterise diagnostic pathways in routine practice. Indicator variables characterised the patient’s keratinocyte carcinoma and dermatologist history, presentation pattern, procedure types, number of visits and procedures, and the activity on the diagnosis date. 2 tests and Pearson residuals were used. We characterised clusters by the lengths of their DI, primary care subinterval and specialist care subinterval.
Results
There were 33 371 patients diagnosed with melanoma from 2007 to 2019. We identified four diagnostic pathways: ‘primary care only’ (n=6107), ‘referred to specialist with immediate action’ (n=8987), ‘multiple visits and procedures in specialist care’ (n=11 893) and ‘specialist care only’ (n=6384). Patient, disease and DI characteristics varied across pathways. Pathway types varied regionally. A higher proportion in the ‘primary care only’ pathway lived in rural areas whereas a higher proportion in the ‘referred to specialist for immediate action’ and the ‘specialist care only’ pathways lived in major urban centres. Across pathways, the median DI varied from 1 to 67 days, the median primary care subinterval varied from 1 to 30 days and the median specialist care subinterval varied from 1 to 25 days. Patients in the ‘primary care only’ pathway experienced the shortest DIs, and patients in the ‘multiple visits and procedures in specialist care’ pathway experienced the longest DIs.
Conclusions and relevance
We identified four melanoma diagnostic pathways. The shortest DI, the ‘primary care only’ pathway, highlights the important role of primary care and the need to reduce the wait for specialists. Diagnostic processes varied across geographical locations. Future research should address reasons for these differences, including whether they are associated with inefficient or inappropriate care.
Real-world outcomes in patients with melanoma brain metastasis: a US multisite retrospective chart review study of systemic treatments
Objective
This study examined real-world treatment patterns and outcomes in patients with melanoma brain metastasis (MBM) treated with first-line immunotherapy consisting of nivolumab plus ipilimumab or anti-programmed death-1 (PD-1) monotherapy (nivolumab or pembrolizumab) or targeted therapy consisting of BRAF/MEK inhibitors.
Design
Retrospective chart review study.
Setting
Academic medical centres, community hospitals and private practice offices.
Participants
Included patients diagnosed with melanoma with brain metastasis in the USA.
Outcome measures
The statistical analysis was descriptive in nature. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method and compared between treatments in a univariate Cox proportional hazards model.
Results
In total, 472 patients with MBM who received first-line nivolumab plus ipilimumab (n=246), anti-PD-1 monotherapy (n=112) or BRAF/MEK inhibitors (n=114) were identified. Patients receiving nivolumab plus ipilimumab, compared with patients receiving anti-PD-1 monotherapy or BRAF/MEK inhibitors, had favourable baseline prognostic factors, such as younger age, fewer or smaller brain metastases, better Eastern Cooperative Oncology Group performance status and less frequently elevated lactate dehydrogenase. Median follow-up times were 15.4 months (range 0.1 to 37.0), 13.3 months (range 0.3 to 36.6) and 13.9 months (range 1.9 to 36.5), respectively. Numerically longer OS was observed with nivolumab plus ipilimumab versus anti-PD-1 monotherapy (HR 0.47, 95% CI 0.34 to 0.67) or BRAF/MEK inhibitors (HR 0.72, 95% CI 0.50 to 1.04) and numerically longer PFS was observed with nivolumab plus ipilimumab versus anti-PD-1 monotherapy (HR 0.74, 95% CI 0.53 to 1.02) or BRAF/MEK inhibitors (HR 0.82, 95% CI 0.60 to 1.12). With nivolumab plus ipilimumab, anti-PD-1 monotherapy and BRAF/MEK inhibitors, 1-year OS rates were 79%, 60% and 72%, respectively; 1-year PFS rates were 68%, 58% and 59%.
Conclusions
In this real-world study, first-line nivolumab plus ipilimumab appeared to provide benefit versus anti-PD-1 monotherapy and BRAF/MEK inhibitors in patients with MBM, consistent with pivotal trial data. However, the observed benefit may have been due to confounding and selection bias, given that patients receiving nivolumab plus ipilimumab had favourable baseline prognostic factors compared with patients receiving anti-PD-1 monotherapy or BRAF/MEK inhibitors.
Melanoma, +30% di diagnosi nel 2024 ma cresce l'immunoterapia
Ascierto, il 50% dei pazienti metastatici sopravvive a 10 anni dalla diagnosi
Checkpoint Immunotherapy for Melanoma — Offering Hope for Cure
New England Journal of Medicine, Volume 392, Issue 1, Page 81-82, January 2, 2025.
Impact of alternative diagnostic labels for melanoma in situ on management choices and psychological outcomes: protocol for an online randomised study
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).
Melanoma, l'immunoterapia 'dual block' diventa standard
Ascierto, +25% di sopravvivenza in forme malattia avanzate
Melanoma, occhio alla tintarella sulla neve. Solo 1 su 10 si protegge
Ascierto, ‘dai raggi solari ci si deve difendere anche in inverno’
Melanoma, terapia con virus modificato per i casi difficili
Efficace nel 30% dei pazienti che non risponde alle altre cure