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Advances in Adjuvant Therapy: Potential for Prognostic and Predictive Biomarkers

  • Diwakar Davar
  • Ahmad A. Tarhini
  • Helen Gogas
  • John M. Kirkwood
Part of the Methods in Molecular Biology book series (MIMB, volume 1102)

Abstract

Melanoma is the third most common skin cancer but accounts for the majority of skin cancer-related mortality. The rapidly rising incidence and younger age at diagnosis has made melanoma a leading cause of lost productive years of life and has increased the urgency of finding improved adjuvant therapy for melanoma. Interferon-α was approved for the adjuvant treatment of resected high-risk melanoma following studies that demonstrated improvements in relapse-free survival and overall survival that were commenced nearly 30 years ago. The clinical benefits associated with this agent have been consistently observed across multiple studies and meta-analyses in terms of relapse rate, and to a smaller and less-consistent degree, mortality. However, significant toxicity and lack of prognostic and/or predictive biomarkers that would allow greater risk–benefit ratio have limited the more widespread adoption of this modality.

Recent success with targeted agents directed against components of the MAP-kinase pathway and checkpoint inhibitors have transformed the treatment landscape in metastatic disease. Current research efforts are centered around discovering predictive/prognostic biomarkers and exploring the options for more effective regimens, either singly or in combination.

Key words

Melanoma Adjuvant Interferon IFN-α CTLA-4 Ipilimumab BRAF Vemurafenib Debrafenib MEK Trametinib 

Notes

Funding

This work was supported by Award Number P50 CA121973 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

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Copyright information

© Springer Science+Business Media, New York 2014

Authors and Affiliations

  • Diwakar Davar
    • 1
  • Ahmad A. Tarhini
    • 2
  • Helen Gogas
    • 3
  • John M. Kirkwood
    • 2
  1. 1.Department of MedicineUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Division of Hematology-Oncology, Department of MedicineUniversity of Pittsburgh Medical CenterPittsburghUSA
  3. 3.First Department of MedicineUniversity of Athens Medical SchoolAthensGreece

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