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- Title
Malignes Melanom.
- Authors
Winkler, J.; Buder-Bakhaya, K.; Dimitrakopoulou-Strauss, A.; Enk, A.; Hassel, J.
- Abstract
Clinical issue: The incidence of malignant melanoma is continuously increasing. The prognosis of metastatic disease is still limited. Standard treatment: Until a few years ago palliative chemotherapy with a limited response rate was the standard treatment for metastatic melanoma. Treatment innovations: Immunotherapy and targeted therapy provide new treatment options. Immune checkpoint inhibitors have significantly improved the prognosis. Diagnostic work-up: Regional lymph node sonography, computed tomography (CT) of the neck, chest and abdomen and brain magnetic resonance imaging (MRI) are routinely used. As an alternative to CT scans 18 F fluorodeoxyglucose positron emission tomography (FDG-PET) may be used. Performance and achievements: Immunotherapy provides the chance of long-term disease control in metastatic melanoma. Ipilimumab may provide long-term tumor control in approximately 20% of patients. Median overall survival of approximately 2 years is achieved during therapy with anti-programmed cell death (PD) 1 antibodies. For combined therapy of ipilimumab and nivolumab a response rate of almost 60% is achieved and 2-year survival is also approximately 60%. The range of immune-mediated side effects demands particular consideration. For response evaluation immune-related response criteria were defined. Furthermore, immunotherapeutic approaches, such as talimogene laherparepvec (T-VEC), which is a modified herpes virus can be used for intralesional injection. Practical recommendations: An individual definition of the appropriate therapy for each patient is of particular importance. In the context of modern therapy regimens close patient monitoring is crucial.
- Publication
Der Radiologe, 2017, Vol 57, Issue 10, p814
- ISSN
0033-832X
- Publication type
Article
- DOI
10.1007/s00117-017-0281-4