Article Dans Une Revue European Journal of Cancer Année : 2025

European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment – Update 2024

1 Eberhard Karls Universität Tübingen = University of Tübingen
2 Unicatt - Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma]
3 Fondazione Policlinico Universitario Agostino Gemelli IRCCS
4 UKSH - University Medical Center of Schleswig–Holstein = Universitätsklinikum Schleswig-Holstein
5 Charles University, Faculty of Education [Prague]
6 HIPI (UMR_S_976 / U976) - Immunologie humaine, physiopathologie & immunothérapie
7 OUH - Odense University Hospital
8 King‘s College London
9 Ghent University Hospital
10 ULB - Université libre de Bruxelles
11 INCIT - Immunology and New Concepts in ImmunoTherapy
12 Princess Máxima Center for Pediatric Oncology [Utrecht, Netherlands]
13 IRCCS - Centro San Giovanni di Dio, Fatebenefratelli, Brescia
14 UMPCD - University of Medicine and Pharmacy “Carol Davila”
15 Medizinische Universität Wien = Medical University of Vienna
16 Frankfurt University Hospital
17 Maastricht University [Maastricht]
18 Aristotle University of Thessaloniki
19 UNIMORE - Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia
20 UAB - Universitat Autònoma de Barcelona = Autonomous University of Barcelona = Universidad Autónoma de Barcelona
21 Hospital Universitario Virgen Macarena [Séville]
22 Mount Vernon Cancer Centre
23 Azienda Ospedaleria Universitaria di Modena = University Hospital of Modena
24 UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
25 RUB - Ruhr University Bochum = Ruhr-Universität Bochum
26 NKUA - National and Kapodistrian University of Athens
27 The University of Sydney
28 UC - Universidade de Coimbra = University of Coimbra [Portugal]
29 Università degli studi di Trieste = University of Trieste
30 University of Manchester [Manchester]
31 UNIPG - Università degli Studi di Perugia = University of Perugia
32 Ospedale "Santa Maria della Misericordia" = University Hospital "Santa Maria della Misericordia"

Résumé

A unique collaboration of multi-disciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF), and the European Organization of 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 one to two-centimeter safety margins. For a correct stage classification and treatment decision, a sentinel lymph node biopsy shall be offered in patients with tumor 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 should be primarily made by an interdisciplinary oncology team ("Tumor Board"). Adjuvant therapies can be proposed in completely resected stage IIB-IV. In stage II only PD-1 inhibitors are approved. In stage III anti-PD-1 therapy or dabrafenib plus trametinib for patients with BRAFV600 mutated melanoma can be discussed. In resected stage IV, nivolumab can be offered, as well as ipilimumab and nivolumab, in selected, high-risk patients. In patients with clinically detected macroscopic, resectable disease, neoadjuvant therapy with ipilimumab plus nivolumab followed complete surgical resection and adjuvant therapy according to pathological response and BRAF status can be offered. Neoadjuvant therapy with pembrolizumab followed by complete surgical resection and adjuvant pembrolizumab is also recommended. For patients with disease recurrence after (neo) adjuvant therapy, further treatment should consider the type of (neo) adjuvant therapy received as well as the time of recurrence, i.e., on or off therapy. In patients with irresectable stage III/IV disease systemic treatment is always indicated. For first line treatment PD-1 antibodies alone or in combination with CTLA-4 or LAG-3 antibodies shall be considered. In stage IV melanoma with a BRAFV600 mutation, first-line therapy with BRAF/MEK inhibitors can be offered as an alternative to immunotherapy, in selected cases. In patients with primary resistance to immunotherapy and harboring a BRAFV600 mutation, this therapy shall be offered as second line. Other second line therapies include therapy with tumor infiltrating lymphocytes and combinations of immune checkpoint inhibitors not used in first line. This guideline is valid until the end of 2026.

Dates et versions

inserm-04861378 , version 1 (02-01-2025)

Identifiants

Citer

Claus Garbe, Teresa Amaral, Ketty Peris, Axel Hauschild, Petr Arenberger, et al.. European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment – Update 2024. European Journal of Cancer, 2025, 215, pp.115153. ⟨10.1016/j.ejca.2024.115153⟩. ⟨inserm-04861378⟩
56 Consultations
0 Téléchargements

Altmetric

Partager

More