Microinvasive melanoma: Cutaneous pharmacotherapeutic approaches Journal Article
| Authors: | Quigley, E. A.; Halpern, A. C. |
| Article Title: | Microinvasive melanoma: Cutaneous pharmacotherapeutic approaches |
| Abstract: | Surgical excision is the treatment of choice for primary melanomas and radiation therapy is the accepted alternative for the subset of lesions not amenable to surgery. With the recent rise in melanoma incidence, especially in the elderly, there are a growing number of cases that are neither amenable to surgery nor radiation therapy. In this article, we review pharmacotherapeutic approaches to microinvasive melanoma (invasive radial growth phase melanoma) that might be considered in such circumstances. There are no approved drugs for the treatment of primary melanoma and randomized controlled trials with 5 or more years of follow-up have not been performed. The limited studies and numerous case series in the literature on pharmacologic treatment of primary melanoma have focused on topical therapies. Accordingly, we provide a review of the potential pharmacotherapeutic agents in the treatment of microinvasive melanoma by extrapolating from the available limited literature on the use of fluorouracil, azelaic acid, retinoic acid derivatives, interferon (IFN)-α, imiquimod, and other agents for melanoma in situ, invasive melanoma, and epidermotropic melanoma metastases. Our review indicates that topical fluorouracil and tretinoin are not effective as single agents. The efficacy of azelaic acid, tazarotene, cidofovir, and intralesional IFN-α, interleukin-2, and IFN-β is undefined. Imiquimod is the most studied and promising agent; however, optimal dosage, therapeutic regimen, and survival rates are unknown. In the face of a growing demand for non-surgical treatments, formal clinical trials are needed to ascertain the role of pharmacotherapeutic agents in the treatment of microinvasive melanoma. © 2013 Springer International Publishing Switzerland. |
| Keywords: | immunohistochemistry; cancer survival; treatment outcome; treatment response; aged; aged, 80 and over; survival analysis; cancer surgery; drug tolerability; review; cancer recurrence; cisplatin; fluorouracil; drug efficacy; treatment duration; alpha interferon; follow up; dna synthesis; cancer palliative therapy; bcg vaccine; interleukin 2; melanoma; metastasis; pain; imiquimod; skin neoplasms; tumor volume; antineoplastic combined chemotherapy protocols; granulocyte macrophage colony stimulating factor; risk assessment; chill; fever; pruritus; gel; cancer regression; biopsy, needle; evening dosage; patient compliance; erythema; amelanotic melanoma; neoplasm invasiveness; cidofovir; flu like syndrome; drug treatment failure; beta interferon; retinoic acid; skin metastasis; xeroderma pigmentosum; retreatment; topical treatment; burning sensation; ulcer; sensitization; cutaneous melanoma; geriatric assessment; interferon-alpha; desquamation; skin allergy; dicarboxylic acids; cryotherapy; fotemustine; metastatic melanoma; randomized controlled trial (topic); tazarotene; pharmaceutical preparations; contact dermatitis; vitiligo; wide excision; aminoquinolines; epidermoid cyst; cytokine release syndrome; cream; erosion; diphencyprone; application site reaction; retinol derivative; azelaic acid; secondary infection; 1 chloro 2,4 dinitrobenzene; rose bengal; disease clearance; eczema; microinvasive melanoma; satellite metastasis |
| Journal Title: | American Journal of Clinical Dermatology |
| Volume: | 14 |
| Issue: | 2 |
| ISSN: | 1175-0561 |
| Publisher: | Adis International Ltd |
| Date Published: | 2013-04-01 |
| Start Page: | 125 |
| End Page: | 137 |
| Language: | English |
| DOI: | 10.1007/s40257-013-0012-1 |
| PROVIDER: | scopus |
| PUBMED: | 23479385 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 August 2013" - "CODEN: AJCDC" - "Source: Scopus" |
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