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Carter TJ, George C, Harwood C, Nathan P. Melanoma in pregnancy: Diagnosis and management in early-stage and advanced disease. Eur J Cancer 2022; 166:240-253. [PMID: 35325701 DOI: 10.1016/j.ejca.2022.02.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/30/2022] [Accepted: 02/18/2022] [Indexed: 12/13/2022]
Abstract
Approximately one-third of women diagnosed with melanoma are of child-bearing age. The annual incidence of melanoma has risen steadily over the last 40 years, resulting in increasing numbers of women diagnosed with melanoma both during pregnancy, and post-partum. To date, there are no formal guidelines on the management of pregnancy associated melanoma (PAM), both early stage and metastatic. This article reviews the existing literature and provides a framework for the investigation and multidisciplinary management of PAM.
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Affiliation(s)
- Thomas J Carter
- Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex, UK
| | - Christina George
- Department of Dermatology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Catherine Harwood
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - Paul Nathan
- Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex, UK.
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Schrom S, Hebesberger T, Wallner SA, Anders I, Richtig E, Brandl W, Hirschmugl B, Garofalo M, Bernecker C, Schlenke P, Kashofer K, Wadsack C, Aigelsreiter A, Heitzer E, Riedl S, Zweytick D, Kretschmer N, Richtig G, Rinner B. MUG Mel3 Cell Lines Reflect Heterogeneity in Melanoma and Represent a Robust Model for Melanoma in Pregnancy. Int J Mol Sci 2021; 22:ijms222111318. [PMID: 34768746 PMCID: PMC8583216 DOI: 10.3390/ijms222111318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/22/2022] Open
Abstract
Melanomas are aggressive tumors with a high metastatic potential and an increasing incidence rate. They are known for their heterogeneity and propensity to easily develop therapy-resistance. Nowadays they are one of the most common cancers diagnosed during pregnancy. Due to the difficulty in balancing maternal needs and foetal safety, melanoma is challenging to treat. The aim of this study was to provide a potential model system for the study of melanoma in pregnancy and to illustrate melanoma heterogeneity. For this purpose, a pigmented and a non-pigmented section of a lymph node metastasis from a pregnant patient were cultured under different conditions and characterized in detail. All four culture conditions exhibited different phenotypic, genotypic as well as tumorigenic properties, and resulted in four newly established melanoma cell lines. To address treatment issues, especially in pregnant patients, the effect of synthetic human lactoferricin-derived peptides was tested successfully. These new BRAF-mutated MUG Mel3 cell lines represent a valuable model in melanoma heterogeneity and melanoma pregnancy research. Furthermore, treatment with anti-tumor peptides offers an alternative to conventionally used therapeutic options—especially during pregnancy.
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Affiliation(s)
- Silke Schrom
- Division of Biomedical Research, Medical University of Graz, 8036 Graz, Austria; (S.S.); (T.H.); (S.A.W.); (I.A.)
| | - Thomas Hebesberger
- Division of Biomedical Research, Medical University of Graz, 8036 Graz, Austria; (S.S.); (T.H.); (S.A.W.); (I.A.)
| | - Stefanie Angela Wallner
- Division of Biomedical Research, Medical University of Graz, 8036 Graz, Austria; (S.S.); (T.H.); (S.A.W.); (I.A.)
| | - Ines Anders
- Division of Biomedical Research, Medical University of Graz, 8036 Graz, Austria; (S.S.); (T.H.); (S.A.W.); (I.A.)
| | - Erika Richtig
- Department of Dermatology, Medical University of Graz, 8036 Graz, Austria;
| | - Waltraud Brandl
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (W.B.); (B.H.); (C.W.)
| | - Birgit Hirschmugl
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (W.B.); (B.H.); (C.W.)
- BioTechMed-Graz, 8010 Graz, Austria; (S.R.); (D.Z.)
| | - Mariangela Garofalo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35122 Padova, Italy;
| | - Claudia Bernecker
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria; (C.B.); (P.S.)
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria; (C.B.); (P.S.)
| | - Karl Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8036 Graz, Austria; (K.K.); (A.A.)
| | - Christian Wadsack
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (W.B.); (B.H.); (C.W.)
- BioTechMed-Graz, 8010 Graz, Austria; (S.R.); (D.Z.)
| | - Ariane Aigelsreiter
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8036 Graz, Austria; (K.K.); (A.A.)
| | - Ellen Heitzer
- Institute of Human Genetics, Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, 8036 Graz, Austria;
| | - Sabrina Riedl
- BioTechMed-Graz, 8010 Graz, Austria; (S.R.); (D.Z.)
- Institute of Molecular Biosciences, Biophysics Division, University of Graz, 8010 Graz, Austria
- BioHealth, 8010 Graz, Austria
| | - Dagmar Zweytick
- BioTechMed-Graz, 8010 Graz, Austria; (S.R.); (D.Z.)
- Institute of Molecular Biosciences, Biophysics Division, University of Graz, 8010 Graz, Austria
- BioHealth, 8010 Graz, Austria
| | - Nadine Kretschmer
- Institute of Pharmaceutical Sciences, Department of Pharmacognosy, University of Graz, 8010 Graz, Austria;
| | - Georg Richtig
- Division of Oncology, Medical University of Graz, 8036 Graz, Austria;
| | - Beate Rinner
- Division of Biomedical Research, Medical University of Graz, 8036 Graz, Austria; (S.S.); (T.H.); (S.A.W.); (I.A.)
- BioTechMed-Graz, 8010 Graz, Austria; (S.R.); (D.Z.)
- Correspondence: ; Tel.: +43-316-3857-3524
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Zelin E, Conforti C, Giuffrida R, Deinlein T, di Meo N, Zalaudek I. Melanoma in pregnancy: certainties unborn. Melanoma Manag 2020; 7:MMT48. [PMID: 32922730 PMCID: PMC7475795 DOI: 10.2217/mmt-2020-0007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 06/15/2020] [Indexed: 12/20/2022] Open
Abstract
Melanoma diagnosed during childbearing period or up to 1 year after delivery is defined as pregnancy-associated melanoma (PAM). There is some evidence that PAM has worse prognosis if compared with melanoma in nonpregnant women, although literature is still inconclusive. Many biological mechanisms could explain this behavior, such as hormonal and immune status, increased lymphangiogenesis but also delay in diagnostic and therapeutic management. If PAM is suspected, a prompt excisional biopsy under local anesthesia can be performed regardless of the gestational period. Conversely, additional staging procedures (such as sentinel lymph node biopsy or imaging) and systemic therapy are still debatable during pregnancy. A multidisciplinary tailored approach should be preferred, together with exhaustive counseling of the mother.
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Affiliation(s)
- Enrico Zelin
- Dermatology & Venereology Department, Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Claudio Conforti
- Dermatology & Venereology Department, Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Roberta Giuffrida
- Department of Clinical & Experimental Medicine, Dermatology, University of Messina, Messina, Italy
| | - Teresa Deinlein
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Nicola di Meo
- Dermatology & Venereology Department, Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Dermatology & Venereology Department, Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
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