European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment – Update 2019 - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue European Journal of Cancer Année : 2020

European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment – Update 2019

Claus Garbe
  • Fonction : Auteur correspondant
  • PersonId : 1080666

Connectez-vous pour contacter l'auteur
Teresa M.S. Amaral
  • Fonction : Auteur
Ketty Peris
  • Fonction : Auteur
Axel Hauschild
  • Fonction : Auteur
Petr Arenberger
Lars Bastholt
Véronique Bataille
  • Fonction : Auteur
Véronique del Marmol
  • Fonction : Auteur
Maria Concetta Fargnoli
Christoph Höller
  • Fonction : Auteur
Roland Kaufmann
  • Fonction : Auteur
Aimilios Lallas
Josep Malvehy
Mark R. Middleton
  • Fonction : Auteur
David Moreno-Ramirez
  • Fonction : Auteur
Giovanni Pellacani
Alexander John Stratigos
  • Fonction : Auteur
Ricardo Vieira
Iris Zalaudek
Alexander M.M. Eggermont
  • Fonction : Auteur

Résumé

A unique collaboration of multidisciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization for Research and Treatment of Cancer (EORTC) was formed to make recommendations on cutaneous melanoma diagnosis and treatment, based on systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with 1- to 2-cm safety margins. Sentinel lymph node dissection shall be performed as a staging procedure in patients with tumour thickness ≥1.0 mm or ≥0.8 mm with additional histological risk factors, although there is as yet no clear survival benefit for this approach. Therapeutic decisions in stage III/IV patients should be primarily made by an interdisciplinary oncology team (“Tumor Board”). Adjuvant therapies in stage III/IV patients are primarily anti–PD-1, independent of mutational status, or dabrafenib plus trametinib for BRAF-mutant patients. In distant metastasis, either resected or not, systemic treatment is indicated. For first-line treatment, particularly in BRAF wild-type patients, immunotherapy with PD-1 antibodies alone or in combination with CTLA-4 antibodies shall be considered. In particular scenarios for patients with stage IV melanoma and a BRAF-V600 E/K mutation, first-line therapy with BRAF/MEK inhibitors can be offered as an alternative to immunotherapy. In patients with primary resistance to immunotherapy and harbouring a BRAF-V600 E/K mutation, this therapy shall be offered in second-line. Systemic therapy in stage III/IV melanoma is a rapidly changing landscape, and it is likely that these recommendations may change in the near future.
Fichier principal
Vignette du fichier
PIIS0959804919308342-1.pdf (379.25 Ko) Télécharger le fichier
Origine Fichiers éditeurs autorisés sur une archive ouverte
Licence

Dates et versions

hal-03228160 , version 1 (10-06-2021)

Licence

Identifiants

Citer

Claus Garbe, Teresa M.S. Amaral, Ketty Peris, Axel Hauschild, Petr Arenberger, et al.. European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment – Update 2019. European Journal of Cancer, 2020, 126, pp.159-177. ⟨10.1016/j.ejca.2019.11.015⟩. ⟨hal-03228160⟩
53 Consultations
123 Téléchargements

Altmetric

Partager

Gmail Mastodon Facebook X LinkedIn More