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Skin Cancer & Melanoma

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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.

Melanoma has become the poster cancer for genomic research. The identification of a driver mutation in the BRAF gene found in approximately 40% of metastatic melanoma patients and the subsequent approval last year of the targeted BRAF inhibitor, vemurafenib, has resulted in a surge of both clinical and laboratory research.

A study published this week shows that taking retinol, a form of vitamin A, results in a decrease in the risk of developing melanoma. The effect is limited to those who took vitamin A in excess of standard multivitamin guidelines and was more pronounced in women than in men.

A large cohort study shows that women on antiestrogen therapy have a lower risk of melanoma. In a study of 7360 women diagnosed with breast cancer between 1980 and 2005, 54% were given supplemental antiestrogen therapy. The rate of cutaneous melanoma was 60% higher for those women not taking antiestrogen supplements compared with the expected rate of melanoma incidence based on age and other factors.

The past year in oncology was highlighted by the continuation of breakthroughs in targeted therapies-with new treatments receiving US Food and Drug Administration (FDA) approval for non–small-cell lung cancer (NSCLC), lymphoma, and melanoma.