What is the current situation of melanoma in Spain?
The incidence of melanoma is increasing in recent decades. Although the anticipated diagnosis facilitates the detection of a greater number of cases in initial stages, mortality has also increased in recent years. It is estimated that the incidence in Spain of melanoma is 5 cases per 100,000 inhabitants. This pathology is detected more frequently in the young population, a third of the cases are diagnosed in people under 50 years of age. In recent years, in order to prevent melanoma, public awareness and information campaigns are being carried out.
How is melanoma different in early stages of advanced melanoma?
Through the dermatological examination in units specialized in pigmented skin lesions, it is possible to diagnose many lesions in time, that is, when they are still in situ or low risk tumors.. Today, most melanomas are detected in early stages, when they can still be cured. However, when the melanoma spreads, it becomes a disease of complicated healing. Until a few years ago, the treatments were very limited, basically they were reduced to chemotherapy, with poor results.
Advanced melanoma is one of the most aggressive tumors. However, it is one of the few tumors that can be eliminated when the immune system is stimulated in the proper way. In addition, it is one of the tumors in which the main key genetic alterations in the development of the tumor are already known, which allows the use of specific treatments based on the molecular profile with better results and less toxicity.
What are the new advances in the treatment of advanced melanoma?
Multiple genetic alterations have been recognized in melanoma. Basically, the mutations of the BRAF, CKIT and NRAS genes are susceptible at the moment to be pharmacologically inhibited.. For the diagnosis of these genetic alterations of melanoma, in addition to the traditional biopsy, it is of special interest to detect blood, as if it were a biopsy but, on this occasion, "liquid". In this context, we are carrying out clinical studies in the Molecular Oncology Laboratory of the Dr Rosell Oncology Institute (IOR).
Currently, both ipilimumab (monoclonal antibody against CTLA4) and vemurafenib and dabrafenib (BRAFV600 inhibitors) have been approved for the treatment of advanced melanoma.. In Spain they are already available through the option of compassionate use of some anti-PDL1 drugs that obtain high activity rates with long responses and excellent tolerance.
When the disease is detected in advanced stages, a need prevails over the rest: access to an early diagnosis and the best applicable treatments.