Huisarts en wetenschap

, Volume 56, Issue 3, pp 124–128 | Cite as

Systemische behandeling van huidmelanomen

Nascholing

Samenvatting

Kruit WJH. Systemische behandeling van huidmelanomen. Huisarts Wet 2013;56(3):124-8.

Melanomen zijn kwaadaardige woekeringen van melanocyten in huid, slijmvliezen of oogepitheel. De incidentie van met name huidmelanomen vertoont al jaren een sterk stijgende lijn. Zijn er eenmaal uitzaaiingen, dan zijn de vooruitzichten somber. Tot voor kort bood chemotherapie met dacarbazine nog de beste kansen, maar de resultaten waren op zijn best teleurstellend. Nieuwe inzichten in de genetische achtergrond van en de immuunrespons tegen tumoren hebben echter geleid tot gerichte behandelingen (targeted therapies) die een betere prognose beloven. De BRAFremmer vemurafenib en het monoklonale CTLA-4-antilichaam ipilimumab zijn de eerste middelen die de onderzoeksfase gepasseerd zijn, en verdere ontwikkelingen volgen elkaar snel op. De nieuwe therapieën zorgen echter ook voor nieuwe bijwerkingen, die levensbedreigend kunnen zijn wanneer ze niet tijdig herkend worden. Daarom is het ook voor de huisarts van belang daar kennis van te hebben. Nauwgezette controle en begeleiding van patiënten die onder behandeling zijn voor gemetastaseerd melanoom, zijn absoluut noodzakelijk.

Abstract

Kruit WJH. Systemic treatment of cutaneous melanoma. Huisarts Wet 2013;56(3):124-8.

Melanomas are the malignant proliferation of melanocytes in skin, mucous membranes, or epithelia of the eye. The incidence of melanoma, and especially cutaneous melanoma, is increasing. Once metastatic there are no curative options. Until recently, chemotherapy with dacarbazine was the best option, even though results were disappointing. New insights into the genetic background of the immune response to tumours have led to the development of targeted therapies that promise a better prognosis. The BRAF inhibitor vemurafenib and the monoclonal anti-CTLA-4 antibody ipilimumab are the first agents to have completed preclinical testing, and further advances are continually being made. The new therapies, however, are accompanied by new side effects, some of which can be life threatening if not recognized in time. This makes it essential that general practitioners know about these potential side effects, and that patients with metastatic melanoma are closely monitored.

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Copyright information

© Bohn, Stafleu van Loghum 2013

Authors and Affiliations

  1. 1.Daniel den Hoed Oncologisch CentrumErasmus MCRotterdamThe Netherlands

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