What`s new in research and treatment of melanoma skin cancer?

Causes, prevention and early detection

Sunlight and ultraviolet (UV) radiation

Recent studies suggest that there may be 2 exposed to UV rays and the general method of melanoma, but it may be some overlap.

The first link is as a child, teen sun exposure. Melanoma often have a history of early sun sunburn or other risks, although not everyone do it. This early exposure to sunlight can cause skin cells (melanocytes) after many years of DNA to start their path to become melanocytes changes. Some doctors think it may help explain why melanoma usually occurs in the legs and torso are generally not exposed to the sun as much as possible in the adult area.

The second aspect is the melanoma occurs in the arms, neck and face. Long-term exposure to sunlight in these areas, particularly in men. Tanning booths may encourage the development of two kinds of melanoma.

Researchers are looking for how to develop these types of melanoma, ultraviolet radiation results may vary. For example, they may have different genetic changes, which would require them to be treated differently.

Public Education

Most skin cancers are preventable. Reducing the number of skin cancer suffering this disease and loss of life is the best way to educate the public, especially parents, about skin cancer risk factors and warning signs. It is very important for health care professionals and skin cancer survivors to remind everyone that the danger of excessive ultraviolet radiation (from the sun and artificial sources such as tanning beds), how easy it can be to protect your skin from too much ultraviolet radiation.

Melanoma can often be detected early, when it is most likely to be completely cured. Find the most melanoma skin self-examination monthly and understanding the signs of melanoma may be helpful when they are in an early, curable stage.

American Academy of Dermatology (AAD) sponsors an annual free skin cancer screenings across the country. Many local offices of the American Cancer Society works closely "Anti-Dumping Agreement" to provide volunteer registration, coordination, and education related to these free screenings. Find your area for information about these sessions, or for more information call the American Academy of Dermatology. Their phone numbers and Web sites listed in the "Additional Resources" section.

The American Cancer Society recommends that live in the shade, in Australia, part of the promotion, the prevention of skin cancer in the United States to use the slogan message. "Slip! Slop! Slap! And summary" is an attractive way to remember when they go out, slipping on a shirt, slop oil sunscreen, slap a hat and sunglasses on the packaging in order to protect your around the eyes and sensitive skin.

Melanoma DNA research

Scientists have made great progress in the past few years to learn how UV light damages DNA and DNA changes caused by normal skin cells how cancer.

However, some people may inherit the mutated gene (damaged) from their parents. For example, in the CDKN2A gene (P16), causing some melanoma runs in some families. Who have a strong family history of melanoma should be said with cancer genetic counselor or physician experienced in cancer genetics discuss the changes in the gene potential benefits, limitations and shortcomings of the test.

Molecular Staging

Advances in DNA research in melanoma has also been applied to the molecular staging. In normal stage, lymph node from the patient looked at under a microscope to see if the melanoma cells have spread to lymph nodes.

In Molecular Staging, RNA (chemical substances and DNA), from extracts of cells in lymph nodes. Certain types of RNA from melanoma cells, but not by normal lymph node cells. A complex test called reverse transcription-polymerase chain reaction (RT-PCR) was used to detect these types of RNA.

Early studies found that, RT-PCR technique is superior to conventional microscopy detection of melanoma spread to lymph nodes. This test may eventually help to identify some patients who might benefit from additional treatment, such as surgery after immunotherapy. However, some doctors worry that this test may lead to unnecessary treatment of some patients, which is why this test is not currently recommended. Research is currently underway to learn more about how it affects the results should treatment options.

Treatment

Early melanoma can often be cured with surgery, but more advanced melanoma is often more difficult to treat, because the standard cancer treatments such as chemotherapy are not very effective. Newer type of treatment, the treatment of more advanced melanoma have shown great promise.

Immunotherapy

This type of treatment, including more effective in helping the body's immune system attacks the melanocytes in several ways. The ipilimumab (Yervoy), cytokines (α-interferon and interleukin-2), certain forms of BCG immunotherapy, as has been used to treat several melanoma (see "Immunotherapy of melanoma skin cancer.") . These treatments work through a general increase in the body's immune system.

ipilimumab target of CTLA-4 protein, normally suppresses T cell immune response, which may contribute to the survival of melanoma cells. This drug has been shown to help some people with advanced melanoma live longer. Researchers are now trying to determine if it may be useful to the previous course of the disease. Other drugs are now being studied offset of CTLA-4 as well.

Drugs block PD-1 and PD-L1

Melanoma cells in the body can also use other natural ways to help avoid detection by the immune system and destroyed. For example, they often have a protein called PD-L1 on their surface, helping them evade the immune system. New drugs that block PD-L1 protein, or the corresponding PD-1 protein in immune cells called T cells, can help the immune system to recognize melanoma cells and attack them.

In earlier studies, the anti-PD-1 drug called BMS-936558 in about three 10-man melanoma tumor shrinkage, while the PD-L1 (known as BMS-936559) for drug targeting tumor shrinkage of about 210 people. Many tumor response has been acting ever since. Larger These new drug research is being done now.

Melanoma vaccine

In clinical trials, directed melanoma vaccine being studied. Their experimental therapies, there is no proven benefit.

In some respects, these vaccines are similar diseases such as polio, measles, mumps is caused by a virus, to prevent the use of the vaccine. These vaccines typically contain weakened and does not cause disease virus or part of a virus. Vaccines stimulate the body's immune system to destroy more harmful virus types.

In the same way, killed cells (antigen) or parts of melanoma cells, can be used as a vaccine in vivo to stimulate the body's attempt to immune system to destroy the other melanoma cells were injected into the patient. Typically, the cells or antigens mixed with other substances, to help improve the body's immune system as a whole. But unlike, a vaccine to prevent infection, these vaccines are used to treat existing disease.

Effective melanoma vaccine has proven to be a vaccine against the virus harder than. Mixed use of vaccines to treat melanoma research results have so far, but the new vaccine can hold more promise.

In a recent patients with advanced melanoma clinical trials, an increase of high-dose interleukin vaccine -2 (IL-2) an increase of some tumor shrinkage and the length of time, and then began to grow again better than just giving IL-2 alone . But it is unclear if this vaccine can help people live longer.

Other immunotherapy

Other forms of immunotherapy are also being investigated. Some early studies have shown that high doses of chemotherapy and radiation therapy in patients with treatment, then you can shrink the tumor infiltrating lymphocytes (TILS), immune system cells found in tumors, melanoma, and may prolong life as well. Newer research is looking to change certain genes in tumor-infiltrating lymphocytes to them before, and if this can make them more effective in the fight against cancer. This approach looks promising in early studies, but it is complex, only a few centers. These new treatments are being studied further.

Another potential method of treatment of a different type of immune therapy, which may be more effective than any single treatment with advanced malignant melanoma.

Targeted drugs

Doctors have found that melanoma cells changes in certain genes, they attacked these changes have begun to develop a drug. These targeted drugs work differently standard chemotherapy drugs. They may work in some cases, the chemotherapy is not justified. They may also have more serious side effects.

Target BRAF gene changes: one that "targeted therapy of melanoma skin cancer" about half of all melanoma drugs have the BRAF gene, which helps cell growth changes. Called vemurafenib (Zelboraf) of the drug has been shown that many of these tumors shrink, now commonly used in genetic variation for this test positive melanoma.

Other objectives BRAF gene changes, and is currently studying medicine. A drug called dabrafenib those vemurafenib studies similar results. It may have an additional benefit of reducing the cause of cutaneous squamous cell carcinoma, but further tests are needed to make sure. This drug is only through clinical trials at this time.

The MEK gene BRAF gene is in the same intracellular signal transduction pathways. Block, MEK,, is called trametinib, a drug that has been shown, can cause some shrinkage of the BRAF mutation melanoma. Not clear, if the drug as effective BRAF inhibitors, or if it is possible for some melanoma BRAF inhibitors, should not work. This drug is only through clinical trials.

Method is currently being studied in a longer time to shrink the tumor, hoping to combine BRAF inhibitors and MEK inhibitors. Results already promising, showing some side effects (such as the development of other skin cancers) may actually be less common combination, but further research is needed.

Change the target c-kit gene: Certain types of melanoma drugs are often unusual genetic changes. This usually includes melanoma Start:

In the palm of the hand, foot or nail down

Inside the mouth or other mucosal areas

Chronic sun exposure in the area,

These rare malignant melanoma, there are about one-third is called C-KIT gene variation. Some drugs have been used to treat other cancers, such as imatinib (Gleevec) and nilotinib (use Tasigna), known as the target cells C-KIT changes. Clinical trials are now wanted to see if these and other medicines may help people with these types of melanoma.

Target gene or protein changes: Some drugs that target other abnormal genes or proteins, such as sorafenib (Nexavar), bevacizumab (trade name Avastin), temsirolimus matter (TORISEL), everolimus Secretary (Afinitor therapy), is currently being studied in clinical trials of the drug is good.