Skin Cancer & Melanoma

ORLANDO-Sentinel lymph node biopsy, which is widely used to detect micrometastases in melanoma and in breast cancer, can also identify colorectal cancer patients who have metastatic disease and should have adjuvant chemotherapy, Sukamal Saha, MD, reported in a plenary presentation at the Society of Surgical Oncology’s 52nd Annual Cancer Symposium (see Figure).

NEW YORK-Actinic keratoses should be treated or removed, according to the consensus of the American Academy of Dermatology, American Cancer Society, and Skin Cancer Foundation. “It is not merely a cosmetic issue,” said Jeffrey Callen, MD, chief of the Division of Dermatology, University of Louisville. Because of their potential to develop into skin cancer, these lesions should be regarded as a serious health problem, he said at a media briefing sponsored by the Academy as part of its Melanoma/Skin Cancer Detection and Prevention Month.

NEW YORK-The association between intermittent but intense sun exposure and malignant melanoma has long been recognized, though the reasons behind it have not been understood. Researchers have now uncovered mechanisms likely to explain why this specific pattern of sun exposure leads to the deadliest form of skin cancer.

NEW YORK-The American Academy of Dermatology has unveiled three new public service advertising campaigns targeting a broad audience with the message that prevention and early detection are the best weapons against skin cancer.

BETHESDA, Md-The Oncology Drugs Advisory Committee (ODAC) has voted not to recommend that the FDA approve Temodal (temozolomide, Schering) for the first-line treatment of patients with metastatic malignant melanoma. The 10 to 0 vote, with one member abstaining, followed a spirited discussion in which committee members not only questioned the value of Temodal in advanced melanoma, but also that of DTIC-Dome (dacarbazine, Bayer), which the FDA approved in 1975 for treating the disease.

WASHINGTON-Medicare will cover three additional uses of positron emission tomography (PET) for the diagnosis and treatment of cancer. In addition to the previously covered uses for the diagnostic evaluation of solitary pulmonary nodules and for staging non-small-cell lung cancer, PET will now be covered for the detection and localization of recurrent colorectal cancer with rising CEA levels; the staging and characterization of both Hodgkin’s and non-Hodgkin’s lymphoma in place of a gallium scan or lymphangiogram; and the identification of metastases in melanoma recurrence in place of gallium scans.

Dr. Natale Cascinelli, president of the World Health Organization (WHO) Melanoma Program, declared intraoperative lymphatic mapping to be the standard of care for melanoma. He made this statement during his presentation of the abstract, “An Overview on Sentinel Lymph Node Dissection” at the 9th International Congress on Anti-Cancer Treatments in Paris.

The promise of using reverse transcriptase–polymerase chain reaction (RT-PCR) technology for the detection of circulating prostate cancer cells in peripheral blood, although technically feasible at the molecular level, has proven clinically impractical for routine implementation in patient management. Reverse transcriptase–polymerase chain reaction has been successfully applied to detect and quantify (relatively speaking) genes that are differentially expressed in cells and tissues obtained from patients during various stages of malignant growth. In addition, the method has been applied to the detection of circulating cancer cells in peripheral blood using highly specific primer sets for specific molecular targets. These include epithelial cell cytokeratins for breast cancer, as well as enzymes, such as tyrosinase for melanoma and prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) for prostate cancer, using either nonnested or nested methodologies.

ATHENS-High-dose interferon-alfa-2b (Intron A, IFN) is the only regimen shown to improve relapse-free survival in high-risk melanoma and should be considered a reference standard for adjuvant therapy in this disease, John Kirkwood, MD, of the University of Pittsburgh, said in a debate at this year’s European Society for Medical Oncology (ESMO) Congress.

Over the past decade, knowledge of the way in which the immune system can be used to fight cancer has greatly increased.

TORONTO--Swiss researchers have shown that positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (FDG) detects metastases more accurately than conventional imaging techniques in patients with malignant melanoma and increases the cost of staging by only 1.7%

TORONTO--Patients with high-risk melanoma may benefit from use of whole-body 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for primary staging, researchers from the University of Frankfurt/Main reported at the 45th Annual Meeting of the Society of Nuclear Medicine.

Sunscreen can help reduce the risk of malignant melanoma, contrary to the finding of a study that received considerable media

LOS ANGELES--A modified M.D. Anderson biochemotherapy regimen for metastatic melanoma that includes interleukin-2 (IL-2) has antitumor activity and is suitable for testing in a cooperative group setting, according to analysis of pilot trial data. The pilot study precedes the larger phase III ECOG/SWOG 3695 intergroup trial that will compare the regimen to CVD (cisplatin, vinblastine, and dacarbazine).

Developed initially for the treatment of malignant melanoma, lymphatic mapping and sentinel lymph node biopsy have recently been introduced into the treatment of early breast cancer. In breast cancer patients, harvested

Developed initially for the treatment of malignant melanoma, lymphatic mapping and sentinel lymph node biopsy have recently been introduced into the treatment of early breast cancer. In breast cancer patients, harvested

Developed initially for the treatment of malignant melanoma, lymphatic mapping and sentinel lymph node biopsy have recently been introduced into the treatment of early breast cancer. In breast cancer patients, harvested

NEW ORLEANS--Increasing levels of melanoma-inhibiting activity (MIA) protein indicate increasing disease activity in melanoma patients, according to research presented at the American Association for Cancer Research meeting.

BUFFALO, NY--Early studies comparing the combination of chemotherapy and immunotherapy with traditional chemotherapy alone suggest that the combination may improve immune responses in patients with metastatic melanoma, said Thomas Olencki, DO, Department of Hematology/Medical Oncology, Cleveland Clinic Foundation.

In the next 5 to 10 years, we may have the answer to the question of whether vaccines can fulfill their promise to become an effective treatment for melanoma, predict Brian J. Czerniecki, md, PhD, and Isabelle Bedrosian, md, in the latest issue of The Melanoma Letter, a publication of The Skin Cancer Foundation. These researchers are experimenting with a new kind of vaccine to combat disseminated melanoma.

Skin cancer is the most common malignancy in the United States, with approximately 1 million cases being diagnosed in 1997.[1] Of these cases, more than 40,000 will be classified as malignant melanoma, the most serious and aggressive form of skin cancer.[1] The worldwide incidence of melanoma is increasing more rapidly than any other form of cancer, and has shown an increase of about 4% per year in the United States.[1,2]

BETHESDA, Md-Proleukin (al-desleukin, Chiron) has won the backing of the Oncologic Drugs Advisory Committee (ODAC) for a new indication. The panel recommended that the FDA approve the recombinant human inter-leukin-2 as “indicated for the treatment of adult patients with metastatic melanoma.” The FDA approved Proleukin for use in renal cell carcinoma in 1992.

Malignant diseases of the vulva account for an estimated 3% to 5% of gynecologic neoplasia. The pathologic variants are many (Table 1). Squamous cell cancers account for 85% to 90% of these neoplasms. Melanoma, Bartholin gland cancer, Paget’s disease, and the various sarcomas are the other principal neoplasms. The preinvasive forms of the squamous cancer tend to occur in younger women and may be associated with in situ lesions of the cervix, vagina, perineum, and anus.

ORLANDO-A German university study contradicts the belief commonly held by many clinical researchers that malignant melanoma is not sensitive to radiation therapy. Dr. M. Heinrich Seegenschmiedt, of the University of Erlangen-Nurnberg, presented the findings at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

PARIS-At the University of Heidelberg, Dr. Ulrich Keilholz and his colleagues are exploring the molecular determinants of prognosis in melanoma patients. A crucial question is whether patients with no evidence of disease after treatment are actually disease free.

SAN FRANCISCO-The use of interleukin-2 (IL-2, Proleukin) in hematologic malignancies is much less advanced than similar work in metastatic melanoma or renal cell carcinoma.

SAN FRANCISCO-About 8,000 people will die of malignant melanoma in the United States this year, victims of a mortality rate approaching 100% in recurrent disease. Sewa S. Legha, MD, painted this grim picture at the Proleukin First International Congress, sponsored by Chiron. Traditional chemotherapy produces response rates up to 40%, but complete remissions are rare, even with the most aggressive combination therapies.

SAN FRANCISCO-Investigations into the cellular basis of the anticancer activity of recombinant interleukin-2 (IL-2, Proleukin) may lead to immunization against some cancers. That was the prospect suggested by Steven A. Rosenberg, MD, head of the NCI’s Surgery Branch and professor of surgery at George Washington University School of Medicine and Health Sciences, and the Uniformed Services University of the Health Sciences, Bethesda, Md.

VIENNA-Individually tailored vaccines made by transducing a patient’s own melanoma cells with the gene for GM-CSF have proven feasible and safe in a study conducted at the Netherlands Cancer Institute, Amsterdam.

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in