Melanoma treatment

Mhashilkar, A. et al. (2001). Gene therapy — therapeutic approaches and implications. Biotechnol. Adv. 19(4), 279-297. Moller, P. Schadendorf, D. (1997). Somatic gene therapy and its implications in melanoma treatment. Arch. Dermatol. Res. 289(2), 71-77. 

Figure 8.6 Melanoma treatment, showing a patient with ulcerated metastasis from malignant melanoma, (a) Before treatment and (b) after treatment with intravenous bleomycin and electroporation ofthe tumor area under general anesthesia. As can be seen, there are needle marks outside the...

Maleic anhydride malignant melanoma treatment Hydroxyurea malonitrile mfg. 

II. Melanoma Treatment of immunodeficiency in nine patients with... 

The majority of promising drug candidates emerging from marine natural products research to date are potential cancer treatments. Six anti-cancer compounds that are either marine natural products or synthetic analogs of marine natural products have made it to clinical trials. The first of these compounds to enter clinical trials was didemnin B (43), one of a family of cyclic depsipetides isolated from the Caribbean tunicate Trididemnum solidum Didemnin B was advanced to Phase II clinical trials for treatment of small cell lung cancer, myeloma, prostate cancer, and melanoma. Unfortunately, no favorable responses were found so the compound has been withdrawn. Crude extracts of another Caribbean tunicate, Ecteinascidia turbinata, showed extremely... 

Dacarbazine is the most active compound used for treating metastatic melanoma. It is also combined with anthracyclines and other cytostatics in the treatment of different sarcomas and Hodgkin s disease. Dacarbazine may cause severe nausea and vomiting. Myelosuppres-sion results in leukopenia and thrombocytopenia. Alopecia and transient abnormalities in renal and hepatic function also occur. 

A large and rapidly growing number of clinical trials (phase I and phase II) evaluating the potential of DNA vaccines to treat and prevent a variety of human diseases are currently being performed ( http // clinicaltrials.gov) however, there is yet no licensed DNA vaccine product available for use in humans. The clinical trials include the treatment of various types of cancers (e.g., melanoma, breast, renal, lymphoma, prostate, and pancreas) and also the prevention and therapy of infectious diseases (e.g., HIV/ABDS, malaria, Hepatitis B vims, Influenza vims, and Dengue vims). So far, no principally adverse effects have been reported from these trials. The main challenge for the development of DNA vaccines for use in humans is to improve the rather weak potency. DNA vaccines are already commercially available for veterinary medicine for prevention of West Nile Vims infections in horses and Infectious Hematopoetic Necrosis Vims in Salmon. 

Boro nophenyl) alanine (BPA) is a practical boron compound which is clinically used for the treatment of not only malignant melanoma but also of brain tumors, in neutron capture therapy (Scheme 1-40) [105, 152, 153]. Although (pinacolato)di-boron (82) is an excellent reagent to afford the corresponding boronate in 88% yield, it strongly resists the hydrolysis to arylboronic acids. Alternatively, the 1,3-diphenyl-propanediol ester (85) is more convenient to deprotect the diol moiety by catalytic hydrogenolysis [105]. 

Much attention has recently been focused on organoboronic acids and their esters because of their practical usefulness for synthetic organic reactions including asymmetric synthesis, combinatorial synthesis, and polymer synthesis [1, 3, 7-9], molecular recognition such as host-guest compounds [10], and neutron capture therapy in treatment of malignant melanoma and brain tumor ]11]. New synthetic procedures reviewed in this article wiU serve to find further appHcations of organoboron compounds. 

Lomustine is an orally available nitrosurea alkylating agent. Lomustine is converted rapidly to the cis- and frans-4-hydroxy metabolites the range of half-lives of these two metabolites is 2 to 4 hours.25 Lomustine has shown clinical activity in the treatment of Hodgkin s lymphoma and melanoma. Side effects are similar to those of carmustine. Patients should receive only enough drug for one cycle at a time to prevent confusion and accidental overdose. 

While the exact mechanism of action remains unclear, dacarbazine appears to inhibit DNA, RNA, and protein synthesis. Dacarbazine disappears rapidly from the plasma, with a terminal half-life of about 40 minutes. Dacarbazine has shown clinical benefit in the treatment of melanoma, Hodgkin s lymphoma, and soft tissue sarcomas. Side effects include myelosuppression, severe nausea and vomiting, and a flulike syndrome that starts about 7 days after treatment and lasts 1 to 3 weeks. 

Explain the goals of therapy for the treatment of nonmelanoma and melanoma skin cancer. 

Discuss the different treatment options for melanoma with brain metastasis. 

Discuss the role of temozolomide in the treatment of stage IV melanoma with or without central nervous system (CNS) metastasis. 

Stage IIB, IIC, and III melanoma are considered to be high risk because of their potential for recurrence and distant metastasis. The primary treatment modality is surgical excision of the tumor and a lymphadenectomy for patients with positive lymph nodes. 

Interleukin 2 therapy is approved by the Food and Drug Administration (FDA) for the treatment of metastatic melanoma, and it is a reasonable option for patients with this stage of the disease. 

Brain metastasis is common in melanoma, and treatment options for brain metastasis include surgery, radiation, and chemotherapy. The choice of therapy depends on the number of metastatic lesions, accessibility of the lesions for surgery, the presence of neurologic symptoms, and the status of extracranial disease. 

Agarwala SS, Kirkwood JM. Temozolomide, a novel alkylating agent with activity in the central nervous system, may improve the treatment of advanced metastatic melanoma. Oncologist 2000 5 144-151. 

Douglas JG, Margolin K. The treatment of brain metastases from malignant melanoma. Semin Oncol 2002 29 518-524. 

Radiation therapy generally is considered to be the treatment of choice for most patients. Exceptions to this include patients with prior radiation to the treatment site and patients with inherently radioresistant tumors (e.g., melanoma and renal cell carcinoma). The radiation field should include two vertebral bodies above and below the involved area. 

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