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Adjuvant Radiation Therapy in Macroscopic Regional Nodal Melanoma. | LitMetric

Adjuvant Radiation Therapy in Macroscopic Regional Nodal Melanoma.

Cancers (Basel)

Icon Cancer Centre, 1-3 Macarthur Ave, Revesby, NSW 2022, Australia.

Published: November 2024

AI Article Synopsis

Article Abstract

Adjuvant radiation therapy (ART) for macroscopic regional nodal cutaneous melanoma has evolved. A significant step was the discovery of targeted therapies, particularly towards V600E-mutated melanoma, and immunotherapy under its different kinds. Prior to this, the defining trial was the Australia and New Zealand Melanoma Trials Group (ANZMTG) 01.02/Trans-Tasman Radiation Oncology Group (TROG) 02.01 phase III trial that showed that ART using three-dimensional conformal radiotherapy (3DCRT) decreased in-field recurrence by 50% (48 Gray (Gy) in 20 fractions). After the advent of systemic therapies, a trial of the combination targeted therapy of dabrafenib plus trametinib toward BRAF V600-mutant nodal cutaneous melanoma showed that all 35 patients achieved a pathological response. Radiotherapy (RT) was found to be safe to give with concurrent combination therapy. A retrospective immunotherapy study found that in 71 patients that received ART after a first recurrence, further in-field recurrence significantly decreased ( = 0.01). For those tumours that do recur in-field, there are now competing therapies like Talimogene laherparepvec or T-VEC. Generally, ART is now used at the first recurrence. The challenge now is to find which melanomas are truly radiosensitive if ART is to have any future role in this scenario.

Download full-text PDF

Source
http://dx.doi.org/10.3390/cancers16233950DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11640668PMC

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