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Skin Cancer & Melanoma

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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.

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.

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).

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-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.

BETHESDA, Md--Delta-amino-levulinic acid (ALA), a compound found in cells throughout the body, holds potential as an active drug in photodynamic therapy and could provide an alternative to surgery for patients with basal and squamous cell carcinomas, R. Rox Anderson, MD, said at the General Motors Cancer Research Foundation conference.

BETHESDA, Md--Increased numbers of small nevi, large nondysplastic nevi, and clinically dysplastic nevi strongly increase a person's risk of developing melanoma--a finding with major preventive implications, according to investigators in a large, case-control study.