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Treatment of Metastatic Melanoma Patients Bearing c-Kit Mutation Using Imatinib Mesylate

Introduction Malignant melanoma (MM) causes most deaths among patients with skin cancer. Up to the end of 2010, the incidence of melanoma in Beijing (China) was 0.89/100,000, which was much lower than that in many Western countries (such as the United States and Australia). Even so, the number of newly diagnosed melanoma patients annually is not small due to the large population in China. Low incidence…

Brain Metastasis from Esophageal Cancer

Introduction Esophageal cancer (EC) is one of the eight most common cancers throughout the world. The incidence of esophageal cancer varies worldwide with the highest rates in Eastern Asian and Southern African countries and the lowest rates in Western Africa, Central Africa, and Central America ( ). The worldwide incidence and the mortality rate of esophageal cancer are 3.2% and 4.9%, respectively ( ). The most…

The Role of the Receptor for Advanced Glycation End Products in Malignant Melanoma

Introduction Melanoma is a disease of melanocytes, the cells of our skin that produce melanin. Because abnormal growth of melanocytes can be readily followed by visual observation of the skin, early stage melanoma tumors can be easily detected and after surgical resection, patients have a very good prognosis with a 5-year survival of 80–100%. However, once melanoma cells escape the primary tumor and form metastases, the…

Role of CDKN2A Mutations and Other Relevant Genes in Melanoma Predisposition

Introduction Melanoma is an aggressive skin cancer and accounts for the majority of skin cancer deaths, according to the American Cancer Society ( www.cancer.org/research/cancerfactsstatistics/cancerfactsfigures2015/ ). The melanoma incidence rate is increasing worldwide, and the disease is among the top 10 in new cancer cases that occur in developed countries ( ). Although the majority of melanoma cases are sporadic, the risk of developing melanoma rises by…

Pathobiology of Brain Metastases: Molecular Mechanisms

Introduction Metastatic brain tumors (MBT) arise from cancers outside the central nervous system (CNS). They reach the brain either from hematogenous spread or via direct invasion from adjacent tissues. Brain metastases are the most common brain tumors and occur nearly 200,000 times each year in the USA. They comprise about 25% of all cancer metastases and may be seen in about 20–40% of all adult cancer…

Brain Metastases from Melanoma

Introduction Metastatic melanoma in the brain is a serious event in patients with melanoma because it signifies a poor prognosis and has a potentially severe impact on quality of life. In 20% of cases, symptomatic metastases represent the initial site of metastatic spread but they may occur at any time during the course of the disease ( ). Autopsy data indicate that up to 75% of…

Risk Reductions of Recurrence and Mortality in Melanoma Patients Using IFN-α

Introduction Melanoma is the fastest growing malignancy in the United States in terms of incidence. In the year 2015, it is estimated that 73,870 men and women will be diagnosed with cutaneous melanoma in the United States and that 9940 will die as a result of this disease ( ). The American Joint Committee on Cancer (AJCC) staging system divides melanoma patients into four stages that…

Melanoma Metastases Are Underrepresented in Cerebellum Compared with Metastases from Colorectal Cancers

Introduction Epidemiology Brain metastases are estimated to be the most common intracranial malignancy in adults ( ). However, the exact incidence is unknown as epidemiological, clinical, neurosurgical, and autopsy series present different incidence rates due to different patient selections. Autopsy series report the highest incidence rates, as they include asymptomatic metastases in patients with advanced disseminated cancer disease. Autopsy series from the 1970s and 1980s reported…

The Management and Biology of Metastatic Cancers to the Brain

Introduction Brain metastases are a serious consequence of many solid tumors, which can result in significant morbidity and mortality. Approximately 10–20% of cancer patients develop brain metastases, and while the actual incidence of brain metastases is somewhat difficult to quantify, it has been estimated that there were between 21,000 and 43,000 cases of brain metastases in the United States in 2010 ( ). The most common…

Recent therapeutic approaches in myeloma

Research highlights Treatment options for myeloma bone disease have increased during the last years. Denosumab is an RANKL inhibitor that has shown its noninferiority in SRE prevention compared to zoledronic acid. Denosumab may constitute a safer option for patients with impaired renal function, addressing an unmet medical need. Antisclerostin antibodies combined with zoledronic acid seem to be a promising future therapeutic approach. Introduction Multiple myeloma (MM)…

Biological relationship between bone and myeloma cells

Research highlights Myeloma growth leads to an imbalance of osteoclasts and osteoblasts causing osteolytic bone disease. Multiple cell types within the bone marrow influence myeloma cell colonization, survival, and growth or dormancy. Repairing existing bone lesions remains a current challenge in the management of myeloma bone disease. List of abbreviations BAFF B-cell-activating factor, also known as TNFSF13B BM Bone marrow BMAd Bone marrow adipocyte BMME Bone…

The effects of anticancer therapies on bone metastases in breast cancer

Research highlights Bone is the preferred site of metastasis in breast cancer, especially in ER/PR-positive tumors CDK4/6 inhibitors combined with aromatase inhibitors/fulvestrant prolong PFS including in patients with bone metastases In HER2-positive patients with bone metastases new combined therapies and second lines, e.g., T-DM1, improve survival In TNBC patients, immunotherapy with PD-L1 inhibitors combined with chemotherapy is becoming standard of care New bone-targeted therapies continue to…

Targeted radionuclide therapy in bone cancer

Intended figures 1. PSMA PET/CT-illustrating scan of both skeletal and local recurrence 2. “Dual-alpha technology” Introduction When treating patients with primary bone cancers and bone metastatic disease, clinicians need to consider best combinations of the various treatments available. Optimal management requires a multidisciplinary team approach with expertise in bone complications from cancer, medical and radiation oncologists, orthopedic surgeons, interventional radiologists, nuclear medicine physicians, and palliative medicine…

Therapies of bone metastases in castration-resistant prostate cancer

Introduction Prostate cancer (PCa) is the most common cancer in the United States, and its incidence is likely to continue to increase with the increasingly aging population. Majority of patients presents a localized PCa, while less than 5% of patients have a metastatic disease at the time of diagnosis [ ]. While androgen deprivation therapy (ADT) is known to decrease bone mineral density, it still remains…

Bone metastases—current status of bone-targeted treatments

Multidisciplinary management of bone metastases In general, the treatment of bone metastases is aimed at palliating symptoms, with cure only rarely a realistic aim in a few rare malignancies such as lymphoma or germ cell tumors affecting bone. Treatments vary depending on the underlying primary site and biological subtype. External beam radiotherapy, endocrine treatments, chemotherapy, and targeted and immunological therapies are all important. In addition, orthopedic…

Bone-targeted agents and skeletal-related events in breast cancer patients with bone metastases

Introduction One of the first to observe the propensity of breast cancers to form bone metastases was the surgeon, Stephen Paget, who described the site distribution of metastases in 735 cases of breast cancer proposing that the association of metastases in bone from primary breast cancers could not be by chance alone. He wrote in the Lancet (1889): “The evidence seems to be irresistible that in…

Cellular and molecular actions of bisphosphonates

Introduction Bisphosphonates (BPs) are well established as the gold standard treatment for metabolic bone diseases associated with excessive bone destruction, including osteoporosis, bone metastases, and cancer therapy–induced bone loss. By virtue of their ability to chelate calcium ions, BPs bind strongly to the skeleton upon administration, thus selectively affecting bone-resorbing osteoclasts. However, preclinical and epidemiological cancer studies support the notion that BPs have additional beneficial effects…

Role of radiation therapy in patients with bone metastasis

Introduction Bone metastasis is common and is one of the leading causes of complications in the natural history of cancer. The consequences of bone metastasis may compromise quality of life, limit day-to-day activities, threaten life expectancy, and increase medical intervention and expenses. The complications of bone metastases, usually referred to as skeletal-related events (SREs), include pain, hypercalcemia, bone fractures, and nerve compression that may require radiation…

Palliative care for patients with bone metastases

The definition of palliative care In 1990, the WHO defined this term as the active and holistic care of patients with advanced or progressive diseases, including the treatment of pain and other symptoms; it also included aspects of the evolutionary course of curable diseases [ ]. However, the need to incorporate this type of care from the time of diagnosis, and to increase its frequency and…