RT Journal Article
T1 European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2019.
A1 Garbe, Claus
A1 Amaral, Teresa
A1 Peris, Ketty
A1 Hauschild, Axel
A1 Arenberger, Petr
A1 Bastholt, Lars
A1 Bataille, Veronique
A1 Del Marmol, Veronique
A1 Dréno, Brigitte
A1 Fargnoli, Maria Concetta
A1 Grob, Jean-Jacques
A1 Höller, Christoph
A1 Kaufmann, Roland
A1 Lallas, Aimilios
A1 Lebbé, Celeste
A1 Malvehy, Josep
A1 Middleton, Mark
A1 Moreno-Ramirez, David
A1 Pellacani, Giovanni
A1 Saiag, Philippe
A1 Stratigos, Alexander J
A1 Vieira, Ricardo
A1 Zalaudek, Iris
A1 Eggermont, Alexander M M
A1 European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC)
K1 Adjuvant treatment
K1 Cutaneous melanoma
K1 Excisional margins
K1 Interferon-α
K1 Metastasectomy
K1 Sentinel lymph node dissection
K1 Systemic treatment
K1 Tumour thickness
AB 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.
YR 2019
FD 2019-12-19
LK http://hdl.handle.net/10668/14865
UL http://hdl.handle.net/10668/14865
LA en
DS RISalud
RD Apr 6, 2025