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Melanoma Management: From Epidemiology to Treatment and Latest Advances. Cancers (Basel) 2022; 14:cancers14194652. [PMID: 36230575 PMCID: PMC9562203 DOI: 10.3390/cancers14194652] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Melanoma is a major public health issue that claims the lives of thousands of people every year. Furthermore, the outlook for the coming years is not encouraging with increasing morbidity and mortality trends. This review aims to offer an updated overview of various aspects related to cutaneous melanoma, from epidemiology, etiology, clinical presentation, prevention, diagnosis and staging. Moreover, conventional treatments currently available as well as the latest advances in clinical trials regarding new drugs and/or combinations, including nanotechnology-based strategies are also reviewed. Abstract Melanoma is the deadliest skin cancer, whose morbidity and mortality indicators show an increasing trend worldwide. In addition to its great heterogeneity, melanoma has a high metastatic potential, resulting in very limited response to therapies currently available, which were restricted to surgery, radiotherapy and chemotherapy for many years. Advances in knowledge about the pathophysiological mechanisms of the disease have allowed the development of new therapeutic classes, such as immune checkpoint and small molecule kinase inhibitors. However, despite the incontestable progress in the quality of life and survival rates of the patients, effectiveness is still far from desired. Some adverse side effects and resistance mechanisms are the main barriers. Thus, the search for better options has resulted in many clinical trials that are now investigating new drugs and/or combinations. The low water solubility of drugs, low stability and rapid metabolism limit the clinical potential and therapeutic use of some compounds. Thus, the research of nanotechnology-based strategies is being explored as the basis for the broad application of different types of nanosystems in the treatment of melanoma. Future development focus on challenges understanding the mechanisms that make these nanosystems more effective.
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Lim SY, Alavi S, Ming Z, Shklovskaya E, Fung C, Stewart A, Rizos H. Melanoma Cell State-Specific Responses to TNFα. Biomedicines 2021; 9:biomedicines9060605. [PMID: 34073253 PMCID: PMC8230114 DOI: 10.3390/biomedicines9060605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022] Open
Abstract
Immune checkpoint inhibitors that target the programmed cell death protein 1 (PD1) pathway have revolutionized the treatment of patients with advanced metastatic melanoma. PD1 inhibitors reinvigorate exhausted tumor-reactive T cells, thus restoring anti-tumor immunity. Tumor necrosis factor alpha (TNFα) is abundantly expressed as a consequence of T cell activation and can have pleiotropic effects on melanoma response and resistance to PD1 inhibitors. In this study, we examined the influence of TNFα on markers of melanoma dedifferentiation, antigen presentation and immune inhibition in a panel of 40 melanoma cell lines. We report that TNFα signaling is retained in all melanomas but the downstream impact of TNFα was dependent on the differentiation status of melanoma cells. We show that TNFα is a poor inducer of antigen presentation molecules HLA-ABC and HLA-DR but readily induces the PD-L2 immune checkpoint in melanoma cells. Our results suggest that TNFα promotes dynamic changes in melanoma cells that may favor immunotherapy resistance.
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Affiliation(s)
- Su Yin Lim
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia; (S.Y.L.); (Z.M.); (E.S.); (C.F.); (A.S.)
- Melanoma Institute Australia, Sydney, NSW 2065, Australia;
| | - Sara Alavi
- Melanoma Institute Australia, Sydney, NSW 2065, Australia;
- Melanoma Oncology and Immunology, Centenary Institute, Camperdown, NSW 2050, Australia
| | - Zizhen Ming
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia; (S.Y.L.); (Z.M.); (E.S.); (C.F.); (A.S.)
- Melanoma Institute Australia, Sydney, NSW 2065, Australia;
| | - Elena Shklovskaya
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia; (S.Y.L.); (Z.M.); (E.S.); (C.F.); (A.S.)
- Melanoma Institute Australia, Sydney, NSW 2065, Australia;
| | - Carina Fung
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia; (S.Y.L.); (Z.M.); (E.S.); (C.F.); (A.S.)
- Melanoma Institute Australia, Sydney, NSW 2065, Australia;
| | - Ashleigh Stewart
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia; (S.Y.L.); (Z.M.); (E.S.); (C.F.); (A.S.)
- Melanoma Institute Australia, Sydney, NSW 2065, Australia;
| | - Helen Rizos
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia; (S.Y.L.); (Z.M.); (E.S.); (C.F.); (A.S.)
- Melanoma Institute Australia, Sydney, NSW 2065, Australia;
- Correspondence: ; Tel.: +61-02-98502762
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