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An Update on Access to Novel Treatment for Metastatic Melanoma in Europe — A 2024 Survey of the European Melanoma Registry and the European Association of Dermato-Oncology
(Elsevier BV, 2024-11)
Kandolf, L
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Ascierto, P
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Bastholt, L
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Gavrilova, I
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Haanen, J
Advances in cancer treatments have significantly improved their effectiveness, yet access to first-line therapies remains limited. A 2017 survey revealed that over 25% of metastatic melanoma patients in Europe lacked access to recommended therapies. To address this, the European Association of Dermato-Oncology and the European Melanoma Registry conducted a follow-up study on the registration and reimbursement of first-line treatments.A web-based survey using LimeSurvey was distributed to melanoma experts across 27 European countries from February to April 2022 and updated from February to April 2024. The questionnaire covered the percentage of patients receiving recommended treatments, as well as treatment authorization and reimbursement dates for systemic and adjuvant therapies.There has been significant improvement in the registration and reimbursement of BRAFi/MEKi, anti-PD1, and anti-PD1/anti-CTLA4 therapies, increasing from 48%, 63%, and 37% in 2017 to 96%, 96%, and 78% in 2024, respectively. Despite these gains, restrictions persist. Anti-PD1/anti-CTLA4 combination immunotherapy is still not available without restrictions in 48% of the surveyed countries. The nivolumab/relatlimab combination is licensed only for PDL-1-negative melanoma and reimbursed in seven countries of Europe. Tebentafusp is reimbursed in 12 countries and talimogene laherpervec in 6. In 2024, adjuvant treatments for stage III melanoma are reimbursed in 22 countries for dabrafenib/trametinib and 24 of 27 for anti-PD1 antibodies. Pembrolizumab and nivolumab are reimbursed in 16 and 8 countries, respectively, for stage IIB/IIC disease.While there have been improvements in the reimbursement of metastatic melanoma treatments in Europe, challenges and discrepancies remain. Further efforts at European and global levels are needed to harmonize and enhance access to cancer medicines.
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COMPARATIVE ANALYSIS OF PREOPERATIVE AND POSTOPERATIVE DIAGNOSIS IN SKIN MELANOMA
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2021-12)
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Gruev, Vladislav
Introduction: Taking into account the increase in incidence and high mortality in advanced stages, early diagnosis is a prerequisite for successful treatment of melanoma. The aim of this study was to determine the concordance between dermatological (withdermoscopy), surgical and pathohistological diagnosis in patients with a suspicious finding of skin melanoma. Material and methods: A comparison between the clinical and pathohistological diagnosisof patients of both sexes, of all ages, with a referral diagnosis of skin melanoma was made. Results: Out of a total of 535 analyzed cases, 469 (87.5%) had preoperative dermato logical findings. In 329 of these patients the referral diagnosis was in favor of melanoma. In 140 cases with a dermatological finding other than melanoma, a pathohistological finding of melanoma was obtained, 30% with a dermatological finding.In addition to melanoma, in 289 cases out of 329 cases with dermatological findings a pathohistological finding for melanoma was obtained, and in 40 cases a pathohistological finding other than melanoma was obtained. Of 66 cases without dermatological findings, 27 patients with a surgical diagnosis other than melanoma were operated on, with a pathohistological finding for melanoma - 41%. With a diagnosis of melanoma without prior dermatological examination, 39 cases were operated on, of which in 12 cases the pathohistological finding was in support of melanoma. Of 58 patients who underwent dermoscopy, 78% had a matching dermoscopic and pa thohistological diagnosis. Conclusion: The results of this study showed a high percentage of erroneous preope rative diagnoses
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Solitary lung metastasis of malignant melanoma - Case report
(Turkish Respiratory Society; Respiratory Society of Serbia, 2017-04)
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Kochovska Kamchevska Nade
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Bushev Jane
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Smileska Snezana
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Baloski Marjan
Malignant melanoma is increasing last thirty years, one of the most common cancers in young adults (especially women). Primary localization on skin, mouth, intestines, eye. Survival in malignant melanoma stage IV is 10-15%, better prognosis have patients with normal lactate dehydrogenase (LDH). Lung metastases are usually asymptomatic, multiple, nodular. Desmoplastic (neurotropic, spindle cell) melanoma is rare form of infiltrating carcinoma, with diificult diagnosis due to similarity to un-melanocytic lesion as scar, fibroma, cyst. Female patient, 69 years of age, hospitalized for changes seen on chest X-ray. Symptoms: intermittent pain in left shoulder, dyspnea. Profession: housewife, non-smoker, comorbidity: arterial hypertension. Normal lung auscultatory finding. Laboratory: sedimentation 20, hemoglobin 11,9, LDH and tumor markers (CA19-9, CEA, CA 125, CA 15-3) normal. Chest X-ray: left apical, oval, soft-tissue shadowing. Bronchoscopy – without pathological findings. A computed tomographic chest scan showed: in left apicoposterior segment, solid formation with dimensions 18x13,6mm, close to the pleura, that accumulated contrast, two mediastinal lymph nodes 5,7mm and 8,5mm. CT guided transthoracic lung core biopsy was performed. Histopathological diagnosis - Metastatic process of Spindle cell melanoma malignum. Microscopic examination with accumulation of large, pleomorphic cells with deposits of melanin irregularly arranged. The origin and systemic dissemination of the melanoma was investigated. Abdominal ultrasound without abnormalities. Dermatological, ophthalomological, gastroenterohepatological examinationas were performed, but the primary lesion remained unknown. The patient denied to receive proposed oncological and surgical therapy. Two years after, control CT scan, the tumor was 47x43mm, in right lung secondary deposite 11x8mm, increased mediastinal lymph nodes to 18mm.
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Survival and prognosis of patients with cutaneous melanoma on extremities
(Macedonian Association of Anatomists, 2018)
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