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Skin Cancer & Melanoma

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The anti–cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) antibody tremelimumab failed to achieve a significant improvement in survival among patients with metastatic melanoma compared with the standard of care treatments used in the comparator arm, according to the results of a phase III study.

We describe areas where major inroads were initially achieved by targeting angiogenesis and by unraveling pathways in the heterogeneous tumors of mesenchymal origin-spurred by the identification of c-Kit–activating mutations in GIST and the regressions that ensued when tumors harboring these mutations were exposed to the tyrosine kinase inhibitor imatinib (Gleevec).

A new target of melanoma tumors has been identified that may be promising as part of a novel combination therapy for melanoma. In a study published in Nature Medicine, researchers have identified that more than half of melanoma cases, both early and late-stage, may have higher levels of MDM4, a p53-interacting protein.

The new therapies that became available for advanced melanoma over the past year-the anti-CTLA4 antibody ipilimumab (Yervoy) and the selective BRAF inhibitor vemurafenib (Zelboraf)-represent promising new options for these patients, whose prognosis was heretofore almost universally dismal. However, the advent of new treatment strategies has made treatment decisions more complex.