Novedades en inmunología del melanoma / Novel Immunologic Approaches to Melanoma Treatment

Desde la introducción de la inmunoterapia el tratamiento del melanoma ha sufrido una revolución, consiguiéndose cifras de supervivencia superiores a las que se alcanzaban con los tratamientos previos. Los fármacos inmunomoduladores disponibles actualmente van dirigidos principalmente frente a las moléculas de superficie CTLA-4 y PD-1, que ejercen un efecto inhibidor sobre la respuesta inmune antitumoral. Se trata de un tratamiento en pleno proceso de expansión, y la investigación se dirige hacia el descubrimiento de nuevas moléculas, las combinaciones de los fármacos disponibles o la identificación de biomarcadores que permitan seleccionar a los pacientes idóneos para cada terapia (AU)

Approaches to treating melanoma have changed radically since the introduction of immunotherapy, and survival figures are now higher than possible with earlier therapies. The immunomodulators currently available mainly block CTLA-4 (cytotoxicT lymphocyte-associated molecule-4) and PD-1 (programed cell death protein 1) translocated to the cell surface, where they inhibit the antitumor immune response. Treatments blocking these molecules are being more widely used. Research now seeks new molecular targets, the best combinations of available drugs, and biomarkers that can identify ideal candidates for each one (AU)

Novel Immunologic Approaches to Melanoma Treatment. / Novedades en inmunología del melanoma.

Approaches to treating melanoma have changed radically since the introduction of immunotherapy, and survival figures are now higher than possible with earlier therapies. The immunomodulators currently available mainly block CTLA-4 (cytotoxicT lymphocyte-associated molecule-4) and PD-1 (programed cell death protein 1) translocated to the cell surface, where they inhibit the antitumor immune response. Treatments blocking these molecules are being more widely used. Research now seeks new molecular targets, the best combinations of available drugs, and biomarkers that can identify ideal candidates for each one.

Remisión espontánea de verrugas recalcitrantes en niñas tras vacunación frente al virus del papiloma humano / Spontaneous Remission of Recalcitrant Warts in Girls After Human Papillomavirus Vaccination

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Evaluación de la regresión en melanomas primarios sucesivos / Assessment of Regression in Successive Primary Melanomas

INTRODUCCIÓN Y OBJETIVOS: Se ha especulado que en los pacientes que han padecido un melanoma puede existir un aumento de la inmunidad frente a determinados antígenos que expresan los melanocitos tumorales. De este modo, nos planteamos revisar la regresión en pacientes con melanomas primarios sucesivos, que podría constituir un reflejo de ese efecto inmunizante que ejercería el primer melanoma. MATERIAL Y MÉTODOS: Utilizando la base de datos de melanomas de nuestro servicio de dermatología, en el período 2000-2012 se han identificado un total de 19 pacientes con melanomas múltiples no simultáneos (2,56% del total). En esos melanomas se ha estudiado la presencia o ausencia de regresión, junto a otras características clínicas e histológicas de los mismos. RESULTADOS: La presencia de regresión en los últimos melanomas extirpados fue significativamente superior a la observada en los primeros (42,10% frente a un 21,05% respectivamente; p = 0,018). Un 42,10% de los pacientes experimentaron regresión en al menos uno de sus melanomas. Se evidenció presencia de regresión en los 2 melanomas pertenecientes al mismo paciente en un 21,05%. No hubo ningún caso con regresión en el primer melanoma y ausencia de la misma en el segundo, mientras que se apreció regresión en el segundo melanoma y ausencia de la misma en el primero en un 21,05% de los pacientes. CONCLUSIONES: Estos hallazgos sugerirían la posibilidad de un efecto inmunizante por el primer melanoma en algunos pacientes con melanomas múltiples no simultáneos

BACKGROUND AND OBJECTIVES: It has been suggested that patients who have had a melanoma may develop increased immunity against certain antigens expressed by tumor-associated melanocytes. Thus our objective was to review the records of patients with successive primary melanomas to ascertain whether the pattern of regression might indicate the presence of an immunization effect arising from the first melanoma. MATERIAL AND METHODS: A review of all the cases recorded in the melanoma database of our dermatology department between 2000 and 2012 identified 19 patients who had multiple asynchronous melanomas (2.56% of all the cases recorded). We studied the presence or absence of regression in these melanomas and other clinical and histological characteristics. RESULTS: The presence of regression was significantly higher in successive melanomas than in the first tumors identified (42.10% vs 21.05%, P = 0.018). Regression of at least 1 melanoma was observed in 42.10% of the patients studied and regression of 2 melanomas was observed in 21.05%. In no case was regression observed in the first melanoma and not in the second; however, in 21.05% of the patients there was evidence of regression in the second tumor and none in the first. CONCLUSIONS: Our findings suggest the possibility that the first melanoma produces an immunization effect in some patients who develop multiple asynchronous melanomas

Assessment of regression in successive primary melanomas.

INTRODUCTION AND OBJECTIVES: It has been suggested that patients who have had a melanoma may develop increased immunity against certain antigens expressed by tumor-associated melanocytes. Thus our objective was to review the records of patients with successive primary melanomas to ascertain whether the pattern of regression might indicate the presence of an immunization effect arising from the first melanoma. MATERIAL AND METHODS: A review of all the cases recorded in the melanoma database of our dermatology department between 2000 and 2012 identified 19 patients who had multiple asynchronous melanomas (2.56% of all the cases recorded). We studied the presence or absence of regression in these melanomas and other clinical and histological characteristics. RESULTS: The presence of regression was significantly higher in successive melanomas than in the first tumors identified (42.10% vs 21.05%, P=.018). Regression of at least 1 melanoma was observed in 42.10% of the patients studied and regression of 2 melanomas was observed in 21.05%. In no case was regression observed in the first melanoma and not in the second; however, in 21.05% of the patients there was evidence of regression in the second tumor and none in the first. CONCLUSIONS: Our findings suggest the possibility that the first melanoma produces an immunization effect in some patients who develop multiple asynchronous melanomas.