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Bucchi L, Mancini S, Zamagni F, Crocetti E, Dal Maso L, Ferretti S, Baldacchini F, Giuliani O, Ravaioli A, Vattiato R, Bella F, Carrozzi G, Cascone G, Ferrante M, Michiara M, Musolino A, Tumino R, Usticano A, Allotta A, Pollina Addario S, Lacarrubba F, Stanganelli I, Falcini F. North-south differences in incidence and surveillance of cutaneous malignant melanoma in Italy. TUMORI JOURNAL 2024; 110:264-272. [PMID: 38825831 DOI: 10.1177/03008916241255458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
BACKGROUND In Italy, the incidence of cutaneous malignant melanoma is two-fold higher in the north than in the south. This gradient might be associated with differences in incidence trends and disease surveillance. We compared the time trends in incidence rates, mortality rates, dermatologic office visit rates and skin biopsy rates between the Emilia-Romagna Region (northern Italy) and the Sicily Region (southern Italy). METHODS The cancer registries of Parma, Modena, Ferrara and Romagna (current population, 2,606,465) and Catania-Messina-Enna, Siracusa and Ragusa (2,775,019) provided incidence and mortality records for the years 2008-2017. The records of outpatient services delivered in public health facilities were obtained from the two Regional Administrations. Trends in rates were assessed with the estimated average annual percent change. North-south differences were expressed as age-standardised rate ratios. RESULTS In the context of a generalised increasing incidence trend, which was more moderate in the female population of the Sicily Region, the standardised rate ratios were: 5.31 (males) and 5.20 (females) for in situ cutaneous malignant melanoma; 2.10 and 2.07 for invasive cutaneous malignant melanoma, with an excess incidence concentrated in lesions ⩽1.00 mm thick (3.58 and 3.05); 3.00 and 2.44 for dermatologic office visits; and 5.25 and 5.02 for skin biopsies. Mortality was stable in both Regions. CONCLUSIONS In the Emilia-Romagna Region, as compared with the Sicily Region, a higher incidence of cutaneous malignant melanoma -especially of in situ and early invasive cutaneous malignant melanoma- coexisted with a higher level of clinical surveillance. The question of the direction of the cause-effect relationship between increased incidence and increased diagnostic scrutiny remains open.
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Affiliation(s)
- Lauro Bucchi
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Silvia Mancini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Federica Zamagni
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Emanuele Crocetti
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Stefano Ferretti
- Romagna Cancer Registry, Section of Ferrara, Local Health Authority and University of Ferrara, Ferrara, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Rosa Vattiato
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Francesca Bella
- Siracusa Cancer Registry, Provincial Health Authority of Siracusa, Italy
| | - Giuliano Carrozzi
- Modena Cancer Registry, Public Health Department, Local Health Authority, Modena, Italy
| | - Giuseppe Cascone
- Cancer Registry, Provincial Health Authority (ASP), Ragusa, Italy
| | - Margherita Ferrante
- Integrated Cancer Registry of Catania-Messina-Enna, Azienda Ospedaliero-Universitaria Policlinico 'Rodolico-San Marco', Catania, Italy
| | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, Parma University Hospital, Parma, Italy
| | - Antonino Musolino
- Parma Cancer Registry, Medical Oncology Unit, Parma University Hospital, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Rosario Tumino
- Siracusa Cancer Registry, Provincial Health Authority of Siracusa, Italy
| | - Antonella Usticano
- Cancer Registry, Provincial Health Authority (ASP), Ragusa, Italy
- Department of Health Activities and Epidemiological Observatory of Sicily Region, Palermo, Italy
| | - Alessandra Allotta
- Department of Health Activities and Epidemiological Observatory of Sicily Region, Palermo, Italy
| | | | | | - Ignazio Stanganelli
- Skin Cancer Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
- Dermatology Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
- Cancer Prevention Unit, Local Health Authority, Forlì, Italy
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Sladojevic J, Dotlic J, Gazibara T, Matkovic S, Maksimovic N. Longitudinal evaluation of health-related quality of life after removal of high-risk melanoma in a setting where adjuvant therapy is not available. Arch Dermatol Res 2023; 316:27. [PMID: 38060051 DOI: 10.1007/s00403-023-02766-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 08/07/2023] [Accepted: 10/05/2023] [Indexed: 12/08/2023]
Abstract
To evaluate health-related quality of life (HRQoL) of people with a high-risk skin melanoma after completion of the primary surgical treatment over time, as well as, to identify factors associated with better HRQoL at the beginning and at the end of follow-up. The study included subjects with histopathologically confirmed high-risk skin melanoma in clinical stages IIC, IIIA, IIIB, and IIIC, in whom clinical and radiographic signs of the disease were not confirmed after primary surgical treatment. The HRQoL was evaluated using Short Form-36 (SF-36) after completion of primary surgical treatment (start of follow-up) and after 6 to 12 months (end of follow-up). A total of 71 people completed SF-36 at both points in time. There were no significant differences between the initial and the follow-up total HRQoL score (t = 1.118; p = 0.267). At the start of follow-up, having fewer depressive symptoms, better functional status and lower vitamin D serum levels were associated with a better total HRQoL score. At the end of follow-up, having lower Breslow depth and being employed at the start of follow-up, having fewer depressive symptoms and lower C-reactive protein (CRP) serum levels at follow-up, and not developing metastases over follow-up were associated with a higher total HRQoL scores. The HRQoL of people with high-risk melanoma did not change in the year following the complete removal of the tumor. However, presence of depressive symptoms and metastases seem to have the strongest impact on poorer quality of life after surgery.
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Affiliation(s)
| | - Jelena Dotlic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Obstetrics and Gynecology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26A, 11000, Belgrade, Serbia
| | - Suzana Matkovic
- Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Natasa Maksimovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26A, 11000, Belgrade, Serbia.
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Bucchi L, Mancini S, Crocetti E, Dal Maso L, Baldacchini F, Vattiato R, Giuliani O, Ravaioli A, Zamagni F, Bella F, Bidoli E, Caldarella A, Candela G, Carone S, Carrozzi G, Cavallo R, Ferrante M, Ferretti S, Filiberti RA, Fusco M, Gatti L, Gili A, Iacovacci S, Magoni M, Mangone L, Mazzoleni G, Michiara M, Musolino A, Piffer S, Piras D, Rizzello RV, Rosso S, Rugge M, Scala U, Stracci F, Tagliabue G, Toffolutti F, Tumino R, Biggeri A, Masini C, Ridolfi L, Villani S, Palmieri G, Stanganelli I, Falcini F. The descriptive epidemiology of melanoma in Italy has changed - for the better. Ital J Dermatol Venerol 2023; 158:483-492. [PMID: 38015485 DOI: 10.23736/s2784-8671.23.07653-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
A recent research project using data from a total of 40 cancer registries has provided new epidemiologic insights into the results of efforts for melanoma control in Italy between the 1990s and the last decade. In this article, the authors present a summary and a commentary of their findings. Incidence increased significantly throughout the study period in both sexes. However, the rates showed a stabilization or a decrease in men and women aged below 35 years. The risk of disease increased for successive cohorts born until 1973 (women) and 1975 (men) while subsequently tending to decline. The trend towards decreasing tumor thickness and increasing survival has continued, but a novel favorable prognostic factor has emerged since 2013 for patients - particularly for males - with thick melanoma, most likely represented by molecular targeted therapies and immune checkpoint inhibitors. Due to this, the survival gap between males and females has been filled out. In the meanwhile, and despite the incidence increase, dermatologists have not lowered their threshold to perform skin biopsy. Skin biopsy rate has increased because of the increasingly greater volume of dermatologic office visits, but the proportion of skin biopsies out of dermatologic office visits has remained constant. In summary, an important breakthrough in melanoma control in Italy has taken place. Effective interventions have been implemented across the full scope of care, which involve many large local populations - virtually the whole national population. The strategies adopted during the last three decades represent a valuable basis for further steps ahead in melanoma control in Italy.
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Affiliation(s)
- Lauro Bucchi
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Silvia Mancini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy -
| | - Emanuele Crocetti
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Rosa Vattiato
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Federica Zamagni
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Francesca Bella
- Siracusa Cancer Registry, Azienda Sanitaria Provinciale (ASP), Siracusa, Italy
| | - Ettore Bidoli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Giuseppa Candela
- Trapani Cancer Registry, Department of Prevention, Servizio Sanitario Regionale Sicilia, Azienda Sanitaria Provinciale (ASP), Trapani, Italy
| | - Simona Carone
- Taranto Cancer Registry, Unit of Statistics and Epidemiology, ASL Taranto, Taranto, Italy
| | | | | | - Margherita Ferrante
- Integrated Cancer Registry of Catania-Messina-Enna, Rodolico-San Marco Polyclinic University Hospital, Catania, Italy
| | - Stefano Ferretti
- Romagna Cancer Registry - Section of Ferrara, ASL Ferrara, University of Ferrara, Ferrara, Italy
| | - Rosa A Filiberti
- Liguria Cancer Registry, San Martino Polyclinic Hospital IRCCS, Genoa, Italy
| | | | - Luciana Gatti
- Mantova Cancer Registry, Epidemiology Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, Mantua, Italy
| | - Alessio Gili
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | | | - Michele Magoni
- Registry of Brescia Province, Epidemiology Unit, Brescia Health Protection Agency, Brescia, Italy
| | - Lucia Mangone
- Epidemiology Unit, AUSL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, Parma University Hospital, Parma, Italy
| | - Antonino Musolino
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Medical Oncology Unit and Cancer Registry, Parma University Hospital, Parma, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - Daniela Piras
- Sassari Cancer Registry, Azienda Regionale per la Tutela della Salute (ATS), Sassari, Italy
| | - Roberto V Rizzello
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Fabrizio Stracci
- Umbria Cancer Registry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giovanna Tagliabue
- Lombardy Cancer Registry of Varese Province, Cancer Registry Unit, Department of Research, National Cancer Institute IRCCS Foundation, Milan, Italy
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
| | - Rosario Tumino
- Cancer Registry, Department of Histopathology, Provincial Health Authority (ASP), Ragusa, Italy
| | - Annibale Biggeri
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Carla Masini
- Unit of Oncological Pharmacy, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Laura Ridolfi
- Department of Immunotherapy, Cell Therapy and Biobank, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Simona Villani
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy
| | - Giuseppe Palmieri
- Department of Immuno-oncology and Targeted Oncologic Biotherapies, University of Sassari, Sassari, Italy
- Unit of Tumor Genetics, IRGB-CNR, Sassari, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
- Cancer Prevention Unit, ASL Forlì, Forlì-Cesena, Italy
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Patinote C, Raevens S, Baumann A, Pellegrin E, Bonnet PA, Deleuze-Masquéfa C. [1,2,4]triazolo[4,3- a]quinoxaline as Novel Scaffold in the Imiqualines Family: Candidates with Cytotoxic Activities on Melanoma Cell Lines. Molecules 2023; 28:5478. [PMID: 37513350 PMCID: PMC10384284 DOI: 10.3390/molecules28145478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/13/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
Cutaneous melanoma is one of the most aggressive human cancers and is the deadliest form of skin cancer, essentially due to metastases. Novel therapies are always required, since cutaneous melanoma develop resistance to oncogenic pathway inhibition treatment. The Imiqualine family is composed of heterocycles diversely substituted around imidazo[1,2-a]quinoxaline, imidazo[1,2-a]pyrazine, imidazo[1,5-a]quinoxaline, and pyrazolo[1,5-a]quinoxaline scaffolds, which display interesting activities on a panel of cancer cell lines, especially melanoma cell lines. We have designed and prepared novel compounds based on the [1,2,4]triazolo[4,3-a]quinoxaline scaffold through a common synthetic route, using 1-chloro-2-hydrazinoquinoxaline and an appropriate aldehyde. Cyclization is ensured by an oxidation-reduction mechanism using chloranil. The substituents on positions 1 and 8 were chosen based on previous structure-activity relationship (SAR) studies conducted within our heterocyclic Imiqualine family. Physicochemical parameters of all compounds have also been predicted. A375 melanoma cell line viability has been evaluated for 16 compounds. Among them, three novel [1,2,4]triazolo[4,3-a]quinoxalines display cytotoxic activities. Compounds 16a and 16b demonstrate relative activities in the micromolar range (respectively, 3158 nM and 3527 nM). Compound 17a shows the best EC50 of the novel series (365 nM), even if EAPB02303 remains the lead of the entire Imiqualine family (3 nM).
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Affiliation(s)
- Cindy Patinote
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247 F16, (CNRS, ENSCM, Université de Montpellier), 1919 Route de Mende, 34090 Montpellier, France
| | - Sandy Raevens
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247 F16, (CNRS, ENSCM, Université de Montpellier), 1919 Route de Mende, 34090 Montpellier, France
| | - Amélie Baumann
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247 F16, (CNRS, ENSCM, Université de Montpellier), 1919 Route de Mende, 34090 Montpellier, France
| | - Eloise Pellegrin
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247 F16, (CNRS, ENSCM, Université de Montpellier), 1919 Route de Mende, 34090 Montpellier, France
| | - Pierre-Antoine Bonnet
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247 F16, (CNRS, ENSCM, Université de Montpellier), 1919 Route de Mende, 34090 Montpellier, France
| | - Carine Deleuze-Masquéfa
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247 F16, (CNRS, ENSCM, Université de Montpellier), 1919 Route de Mende, 34090 Montpellier, France
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Malvehy J, Dreno B, Barba E, Dirshka T, Fumero E, Greis C, Gupta G, Lacarrubba F, Micali G, Moreno D, Pellacani G, Sampietro-Colom L, Stratigos A, Puig S. Smart e-Skin Cancer Care in Europe During and after the Covid-19 Pandemic: a Multidisciplinary Expert Consensus. Dermatol Pract Concept 2023; 13:e2023181. [PMID: 37557116 PMCID: PMC10412091 DOI: 10.5826/dpc.1303a181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Melanoma is the deadliest of all the skin cancers and its incidence is increasing every year in Europe. Patients with melanoma often present late to the specialist and treatment is delayed for many reasons (delay in patient consultation, misdiagnosis by general practitioners, and/or limited access to dermatologists). Beyond this, there are significant inequalities in skin cancer between population groups within the same country and between countries across Europe. The emergence of the COVID-19 pandemic only aggravated these health deficiencies. OBJECTIVES The aim was to create an expert opinion about the challenges in skin cancer management in Europe during the post COVID-19 acute pandemic and to identify and discuss the implementation of new technologies (including e-health and artificial intelligence defined as "Smart Skin Cancer Care") to overcome them. METHODS For this purpose, an ad-hoc questionnaire with items addressing topics of skin cancer care was developed, answered independently and discussed by a multidisciplinary European panel of experts comprising dermatologists, dermato-oncologists, patient advocacy representatives, digital health technology experts, and health technology assessment experts. RESULTS After all panel of experts discussions, a multidisciplinary expert opinion was created. CONCLUSIONS As a conclusion, the access to dermatologists is difficult and will be aggravated in the near future. This fact, together with important differences in Skin Cancer Care in Europe, suggest the need of a new approach to skin health, prevention and disease management paradigm (focused on integration of new technologies) to minimize the impact of skin cancer and to ensure optimal quality and equity.
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Affiliation(s)
- Josep Malvehy
- Dermatology Department. Hospital Clinic of Barcelona, Spain
- University of Barcelona, Barcelona, Spain. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Biomedical Research Networking Centre on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - Brigitte Dreno
- Department of Dermatolo-Cancerology, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France
| | - Enric Barba
- Spanish Melanoma Association, Barcelona, Spain
| | - Thomas Dirshka
- Centroderm Clinic, Wuppertal, and Faculty of Health, University Witten-Herdecke, Witten, Germany
| | | | - Christian Greis
- Department Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Girish Gupta
- University Department of Dermatology, Edinburgh Royal Infirmary, Lauriston Building, Edinburgh, UK
| | | | | | - David Moreno
- Dermatology Department, University Hospital Virgen Macarena, Seville, Spain
| | - Giovanni Pellacani
- Dermatology Department. Università degli Studi di Roma La Sapienza. Roma, Italy
| | - Laura Sampietro-Colom
- Assessment of Innovations and New Technologies Unit, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Alexander Stratigos
- Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodestrian University of Athens, Athens, Greece
| | - Susanna Puig
- Dermatology Department. Hospital Clinic of Barcelona, Spain
- University of Barcelona, Barcelona, Spain. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Biomedical Research Networking Centre on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
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Liszkay G, Benedek A, Polgár C, Oláh J, Holló P, Emri G, Csejtei A, Kenessey I, Polányi Z, Knollmajer K, Várnai M, Vokó Z, Nagy B, Rokszin G, Fábián I, Barcza Z, Gyulai R, Kiss Z. Significant improvement in melanoma survival over the last decade: A Hungarian nationwide study between 2011 and 2019. J Eur Acad Dermatol Venereol 2023; 37:932-940. [PMID: 36785988 DOI: 10.1111/jdv.18960] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/02/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Recent real-world studies have reported significant improvements in the survival of malignant melanoma in the past few years, mainly as a result of modern therapies. However, long-term survival data from Central Eastern European countries such as Hungary are currently lacking. METHODS This nationwide, retrospective study examined melanoma survival in Hungary between 2011-2019 using the databases of the National Health Insurance Fund (NHIF) and Central Statistical Office (CSO) of Hungary. Crude overall survival and age-standardized 5-year net survival as well as the association between age, sex and survival were calculated. RESULTS Between 2011 and 2019, 22,948 newly diagnosed malignant melanoma cases were recorded in the NHIF database (47.89% male, mean age: 60.75 years (SD: ±16.39)). Five-year overall survival was 75.40% (women: 80.78%; men: 69.52%). Patients diagnosed between 2017-2019 had a 20% lower risk of mortality compared to patients diagnosed between 2011-2012 (HR 0.80, 95% CI 0.73-0.89; p < 0.0001). Age-standardized 5-year net survival rates in 2011-2014 and 2015-2019 were 90.6% and 95.8%, respectively (women: 93.1% and 98.4%, men: 87.8% and 92.7%, respectively). The highest age-standardized 5-year net survival rates were found in the 0-39 age cohort (94.6% in the 2015-2019 period). CONCLUSION Hungary has similar melanoma survival rates to Western European countries. Based on net survival, the risk of dying of melanoma within 5 years was cut by more than half (55%) during the study period, which coincides with the successful implementation of awareness campaigns and the wide availability of modern therapies.
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Affiliation(s)
- Gabriella Liszkay
- Department of Molecular Immunology and Toxicology and the National Tumorbiology Laboratory, National Institute of Oncology, Budapest, Hungary
| | | | - Csaba Polgár
- Department of Molecular Immunology and Toxicology and the National Tumorbiology Laboratory, National Institute of Oncology, Budapest, Hungary
| | - Judit Oláh
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Gabriella Emri
- Department of Dermatology, University of Debrecen, Debrecen, Hungary
| | - András Csejtei
- Department of Oncoradiology, Markusovszky University Teaching Hospital, Szombathely, Hungary
| | - István Kenessey
- Department of Molecular Immunology and Toxicology and the National Tumorbiology Laboratory, National Institute of Oncology, Budapest, Hungary
| | | | | | - Máté Várnai
- MSD Pharma Hungary Ltd., Budapest, Hungary
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Balázs Nagy
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | | | - Ibolya Fábián
- RxTarget Ltd., Szolnok, Hungary
- University of Veterinary Medicine, Budapest, Hungary
| | - Zsófia Barcza
- Syntesia Medical Communications Ltd., Budapest, Hungary
| | - Rolland Gyulai
- Department of Dermatology, Venereology and Oncodermatology, Faculty of Medicine, University of Pécs, Pécs, Hungary
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Dziankowska-Zaborszczyk E, Maniecka-Bryła I, Pikala M. Mortality Trends Due to Skin Melanoma in Poland in the Years 2000-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16118. [PMID: 36498192 PMCID: PMC9739595 DOI: 10.3390/ijerph192316118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/20/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
The aim of this article is to assess mortality trends due to skin melanoma in Poland between the years 2000 and 2020, taking into account gender and place of residence (urban, rural). The subject of the analyses was data on 25,061 deaths that occurred between 2000 and 2020 due to skin melanoma (C43 according to ICD-10). Mortality rates due to this cancer, both crude (CDR) and standardised (SDR), were calculated. Trends on the calculated rates were analysed using the annual percentage change (APC) and average annual percentage change (AAPC), obtained from joinpoint regression models. Over the study period, the standardised death rate (SDR) due to skin melanoma in Poland increased from 3.60 to 4.03 per 100,000 population (AAPC = 1.1; p < 0.05), for urban residents it increased from 3.56 to 3.91 (APC = 1.2; p < 0.05) and for rural residents it increased from 3.00 to 4.24 (APC = 2.2; p < 0.05). A higher growth rate in terms of the SDR value between the years 2000 and 2020 was recorded in men compared to women and in rural when compared to urban residents. In Poland, mortality due to skin melanoma is on the rise. The early diagnosis of this cancer should become common practice in the Polish population.
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Fabregas JC, Carter BT, Lutzky J, Robinson WR, Brant JM. Impact of Medicaid Expansion Status and Race on Metastatic Disease at Diagnosis in Patients with Melanoma. J Racial Ethn Health Disparities 2022; 9:2291-2299. [PMID: 34648145 DOI: 10.1007/s40615-021-01166-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Black patients are diagnosed with melanoma at a later stage, as compared with their white counterparts. It is unknown if Medicaid expansion might ameliorate this disparity. METHODS Using data from the 2016 National Cancer Database, we conducted a retrospective cohort study. The primary objective was to evaluate whether being diagnosed with melanoma at a Medicaid Expansion State (MES) and black race are associated with a late diagnosis of melanoma. Main exposure: Being diagnosed in a MES. Secondary exposure: Race. Main outcome: Odds of Stage IV vs Stages 0-III at diagnosis. Univariate, multivariate logistic regression, and propensity score analyses were conducted to evaluate the potential associations. Sub-group analysis was conducted according to age < 65 or ≥ 65 years. RESULTS A total of 216,604 patients were included, 40-90 years of age, [Formula: see text] 64 years [SD 12.47]. In univariate analysis, patients diagnosed in MES were 15% less likely (95% CI, 0.81-0.88) to be diagnosed with Stage IV melanoma. Black race (vs white) had 3.04 increased odds (95% CI, 2.56-3.60) of late diagnosis. In multivariate analysis, adjusting for socio-economic confounders, patients < 65 years of age were 13% less likely (95% CI, 0.82-0.92) to be diagnosed with Stage IV melanoma. By propensity score analysis, the strength of the associations remained. Black race (vs white) was associated with higher odds (95% CI, 1.91-3.08) of being diagnosed with Stage IV disease. For black patients < 65 years, being diagnosed in a state without Medicaid expansion had 2.55 higher odds (95% CI, 1.93-3.38) of being diagnosed with Stage IV melanoma, which decreased to 2.11 odds (95% CI, 1.34-3.33) in MES. The interaction between race and MES was statistically significant (P = 0.008). CONCLUSIONS This study suggests that patients are less likely to be diagnosed with Stage IV melanoma in MES. This beneficial effect is more pronounced among Black minorities.
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Affiliation(s)
- Jesus C Fabregas
- University of Florida Health Cancer Center, University of Florida, 1600 SW Archer Road, D2-3, Gainesville, FL, 32610, USA
| | - Benjamin T Carter
- Billings Clinic, 2800 Tenth Avenue North, Billings, MT, 59107, USA.,Collaborative Science & Innovation, 2800 Tenth Avenue North, Billings, MT, 59101, USA
| | - Jose Lutzky
- University of Miami - Sylvester Comprehensive Cancer Center, 1475 NW Ave, Floor 2, Miami, FL, 33136, USA
| | - William Russell Robinson
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, J2500 N State St, Jackson, MS, 39216, USA
| | - Jeannine M Brant
- Billings Clinic, 2800 Tenth Avenue North, Billings, MT, 59107, USA.
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Risk factors for cardiovascular mortality and melanoma-specific mortality among patients with melanoma: a SEER based study. Eur J Cancer Prev 2022; 31:293-300. [PMID: 34010239 DOI: 10.1097/cej.0000000000000690] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE This study aims to identify the risk factors for cardiovascular mortality in melanoma patients. METHODS Data of melanoma patients were obtained from the Surveillance, Epidemiology, and End Results database. We used Person's chi-square test to assess the relationships between categorical variables. We used Kaplan-Meier test in the univariate analysis and Cox regression test for the multivariate analysis. Analyses were conducted using the SPSS software. RESULTS We analyzed data of 194 503 melanoma patients. Among them, 28 818 (14.8 %) died due to cardiovascular diseases. Cardiovascular-specific survival was higher in younger patients, women, married, localized disease, superficial spreading melanoma and in patients who had surgery. It was lower in patients who received chemotherapy or radiotherapy. The multivariate analysis revealed a higher risk of cardiovascular mortality in patients aged 50-64 years [hazard ratio (HR), 7.297; 95% confidence interval (CI), 6.68-7.97], patients aged ≥65 years (HR, 43.309; 95% CI, 39.706-47.240), men (HR, 1.535; 95% CI, 1.475-1.597), Blacks (HR, 1.29; 95% CI, 1.044-1.594), separated (HR, 1.286; 95% CI, 1.058-1.562), widowed (HR, 1.829; 95% CI, 1.706-1.961), patients with no or unknown history of chemotherapy (HR, 1.302; 95% CI, 1.071-1.583) or radiotherapy (HR, 1.477; 95% CI, 1.217-1.793) and patients with no surgery (HR, 1.468; 95% CI, 1.264-1.706). CONCLUSIONS In patients with melanoma, the risk of cardiovascular death is higher in older patients, men, Blacks, separated, widowed and patients with nodular or lentigo maligna melanoma. The risk is lower in married, patients with superficial spreading or acral lentiginous melanoma, and patients who had chemotherapy, radiotherapy or surgery.
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Regional variability of melanoma incidence and prevalence in Hungary. Epidemiological impact of ambient UV radiation and socioeconomic factors. Eur J Cancer Prev 2021; 31:377-384. [PMID: 34545023 DOI: 10.1097/cej.0000000000000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The incidence of cutaneous melanoma has risen faster than almost any other type of cancer in the last 50 years. Ultraviolet (UV) radiation and genetic susceptibility are the most important risk factors. OBJECTIVE We aimed to determine the epidemiologic indicators of melanoma in Hungary, a country with an estimated population of 9.8 million and an area of 93 030 km2. METHODS Anonymized patient records from the National Health Insurance Fund Management covering the entire population were used to determine the incidence and prevalence of melanoma in the counties of Hungary from 2013 to 2017. Altogether 20 030 melanoma cases were identified for inclusion in this study. RESULTS The prevalence of melanoma increased over the investigated period and was significantly higher among women than men. The incidence of melanoma stagnated during this period and the incidence rate was the highest among the elderly. Interestingly, the incidence was higher in males in the elderly population, while the incidence was higher in females in the younger (<60 years) population. Geographical variations in ambient UV radiation did not show statistically significant correlation with the regional variability of epidemiologic indicators, probably due to small differences in the number of bright sunshine hours per year between regions. Although Hungary is a relatively small country, we observed regional heterogeneity in socioeconomic factors. Notably, a significant and strong negative correlation was found between single-person household rates and melanoma prevalence. CONCLUSION In addition to ambient UV radiation, melanoma incidence and prevalence appear to be related to age, gender and socioeconomic factors.
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Huang S, Deng W, Wang P, Yan Y, Xie C, Cao X, Chen M, Zhang C, Shi D, Dong Y, Cheng P, Xu H, Zhu W, Hu Z, Tang B, Zhu J. Fermitin family member 2 promotes melanoma progression by enhancing the binding of p-α-Pix to Rac1 to activate the MAPK pathway. Oncogene 2021; 40:5626-5638. [PMID: 34321603 PMCID: PMC8445820 DOI: 10.1038/s41388-021-01954-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 06/06/2021] [Accepted: 07/09/2021] [Indexed: 01/02/2023]
Abstract
We identified fermitin family member 2 (FERMT2, also known as kindlin-2) as a potential target in A375 cell line by siRNA library screening. Drugs that target mutant BRAF kinase lack durable efficacy in the treatment of melanoma because of acquired resistance, thus the identification of novel therapeutic targets is needed. Immunohistochemistry was used to identify kindlin-2 expression in melanoma samples. The interaction between kindlin-2 and Rac1 or p-Rac/Cdc42 guanine nucleotide exchange factor 6 (α-Pix) was investigated. Finally, the tumor suppressive role of kindlin-2 was validated in vitro and in vivo. Analysis of clinical samples and Oncomine data showed that higher levels of kindlin-2 predicted a more advanced T stage and M stage and facilitated metastasis and recurrence. Kindlin-2 knockdown significantly inhibited melanoma growth and migration, whereas kindlin-2 overexpression had the inverse effects. Further study showed that kindlin-2 could specifically bind to p-α-Pix(S13) and Rac1 to induce a switch from the inactive Rac1-GDP conformation to the active Rac1-GTP conformation and then stimulate the downstream MAPK pathway. Moreover, we revealed that a Rac1 inhibitor suppressed melanoma growth and metastasis and the combination of the Rac1 inhibitor and vemurafenib resulted in a better therapeutic outcome than monotherapy in melanoma with high kindlin-2 expression and BRAF mutation. Our results demonstrated that kindlin-2 promoted melanoma progression, which was attributed to specific binding to p-α-Pix(S13) and Rac1 to stimulate the downstream MAPK pathway. Thus, kindlin-2 could be a potential therapeutic target for treating melanoma.
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Affiliation(s)
- Shaobin Huang
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
- The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wuguo Deng
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Peng Wang
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yue Yan
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Chuanbo Xie
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Xiaoling Cao
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Miao Chen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Changlin Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Dingbo Shi
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Yunxian Dong
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Pu Cheng
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hailin Xu
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wenkai Zhu
- Department of Chemistry, Portland State University, Portland, OR, USA
| | - Zhicheng Hu
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| | - Bing Tang
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| | - Jiayuan Zhu
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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García-Souto F, Durán-Romero AJ, Pereyra-Rodríguez JJ. Melanoma mortality in Spain: predictions up to 2043. Int J Dermatol 2021; 60:844-850. [PMID: 33570165 DOI: 10.1111/ijd.15438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/17/2020] [Accepted: 01/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Melanoma mortality rates are stabilizing and in certain regions and age groups are trending down. Although there are some studies that predict melanoma mortality in other countries, there are currently no studies that predict mortality in Spain in the coming years. The main aim of this study is to calculate melanoma mortality projections in Spain for the period 2019-2043. METHODS This is a population-based ecological study that utilized information from the Spanish National Statistics Institute. Analysis included deaths as a result of cutaneous melanoma in Spain in the period 1979-2018, and data was analyzed according to gender and age group. Projections were made until 2043 in five-year periods, calculated in Nordpred (within the R software). RESULTS Our estimates predict that in the period 2019-2043, there will be 30,477.9 deaths from melanoma in Spain, with the age group of >85 years being the group with the highest number of deaths. The expected average annual death rate for melanoma in both genders for the period 2019-2043 is 1,269.9 deaths / year. The predicted age-standardized mortality rates varied between 4.62/100.000 inhabitants in the 2019-2023 period and 3.94/100.000 inhabitants in the 2039-2043 period. CONCLUSIONS Overall mortality rate and age-standardized melanoma death rates in older people of both genders will increase in the coming years in Spain, while rates in younger people will stabilize or decrease progressively. In the coming years, prevention efforts should focus on the young, but the emphasis should also be on educating the elderly in early detection of melanoma.
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Affiliation(s)
| | | | - Jose-Juan Pereyra-Rodríguez
- Department of Dermatology, Virgen del Rocio University Hospital, Sevilla, Spain.,School of Medicine, University of Seville, Spain
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Brown RVS, Hillesheim D, Tomasi YT, Nunes DH. Mortality from malignant skin melanoma in elderly Brazilians: 2001 to 2016. An Bras Dermatol 2021; 96:34-39. [PMID: 33279314 PMCID: PMC7838114 DOI: 10.1016/j.abd.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 08/01/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Malignant skin melanoma is a serious public health problem, especially among the elderly population. Knowing the dynamics of the mortality rates of this disease in Brazil is essential to support the creation of public health policies. OBJECTIVE To analyze the temporal trend of mortality from malignant skin melanoma in elderly people in Brazil, from 2001 to 2016. METHODS This was a descriptive analytical study of mortality rates from malignant skin melanoma in the elderly. The data were obtained from the Mortality Information System, and information related to the population was obtained from the 2010 population census and population estimates from the Brazilian Institute of Geography and Statistics. Mortality coefficients were calculated and simple linear regression analysis of the coefficients was performed by sex and macro-region. RESULTS A total 12,712 deaths due to malignant skin melanoma in the elderly were registered. The majority (56.8%) occurred in the male population. In females, a tendency of increase in mortality rates due to malignant skin melanoma was observed in the Northeast (p ≤ 0.001), Midwest (p = 0.002), and Brazil as a whole (p = 0.003). In males, an upward trend was observed in all regions, except for the Southeast region. For both sexes, there was also an upward trend in all regions, with the exception of the Southeast region. STUDY LIMITATIONS Secondary databases are directly influenced by the quality of death certificate completion and their heterogeneous scope in Brazilian regions. CONCLUSION The increase in mortality indicates a potential public health challenge for the coming decades. The prevention of skin cancer among the elderly should become a priority, mainly through the implementation of preventive measures.
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Umar AB, Uzairu A, Shallangwa GA, Uba S. Computational evaluation of potent 2-(1H-imidazol-2-yl) pyridine derivatives as potential V600E-BRAF inhibitors. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2020. [DOI: 10.1186/s43042-020-00111-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Abstract
Background
V600E-BRAF is a major protein target involved in various types of human cancers. However, the acquired resistance of the V600E-BRAF kinase to the vemurafenib and the side effects of other identified drugs initiate the search for efficient inhibitors. In the current paper, virtual docking screening combined with drug likeness and ADMET properties predictions were jointly applied to evaluate potent 2-(1H-imidazol-2-yl) pyridines as V600E-BRAF kinase inhibitors.
Results
Most of the studied compounds showed better docking scores and favorable interactions with theiV600E-BRAF target. Among the screened compounds, the two most potent (14 and 30) with good rerank scores (−124.079 and − 122.290) emerged as the most effective, and potent V600E-BRAF kinase inhibitors which performed better than vemurafenib (−116.174), an approved V600E-BRAF kinase inhibitor. Thus, the docking studies exhibited that these compounds have shown competing inhibition of V600E-BRAF kinase with vemurafenib at the active site and revealed better pharmacological properties based on Lipinski’s and Veber’s drug-likeness rules for oral bioavailability and ADMET properties.
Conclusion
The docking result, drug-likeness rules, and ADMET parameters identified compounds (14 and 30) as the best hits against V600E-BRAF kinase with better pharmacological properties. This suggests that these compounds may be developed as potent V600E-BRAF inhibitors.
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Durán‐Romero A, Sendín‐Martin M, Conejo‐Mir J, Pereyra‐Rodriguez J. Cutaneous malignant melanoma mortality in Spain from 1979 to 2018. Trends and new perspectives in the immunotherapy era. J Eur Acad Dermatol Venereol 2020; 35:884-891. [DOI: 10.1111/jdv.16983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/22/2020] [Indexed: 12/20/2022]
Affiliation(s)
- A.J. Durán‐Romero
- Dermatology Department Hospital Universitario Virgen del Rocío Sevilla España
| | - M. Sendín‐Martin
- Dermatology Department Hospital Universitario Virgen del Rocío Sevilla España
| | - J. Conejo‐Mir
- Dermatology Department Hospital Universitario Virgen del Rocío Sevilla España
- School of Medicine Sevilla University Sevilla España
| | - J.J. Pereyra‐Rodriguez
- Dermatology Department Hospital Universitario Virgen del Rocío Sevilla España
- School of Medicine Sevilla University Sevilla España
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Patinote C, Deleuze-Masquéfa C, Kaddour KH, Vincent LA, Larive R, Zghaib Z, Guichou JF, Assaf MD, Cuq P, Bonnet PA. Imidazo[1,2-a]quinoxalines for melanoma treatment with original mechanism of action. Eur J Med Chem 2020; 212:113031. [PMID: 33309473 DOI: 10.1016/j.ejmech.2020.113031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/05/2020] [Accepted: 11/14/2020] [Indexed: 10/22/2022]
Abstract
The malignant transformation of melanocytes causes several thousand deaths each year, making melanoma an important public health concern. Melanoma is the most aggressive skin cancer, which incidence has regularly increased over the past decades. We described here the preparation of new compounds based on the 1-(3,4-dihydroxyphenyl)imidazo[1,2-a]quinoxaline structure. Different positions of the quinoxaline moiety were screened to introduce novel substituents in order to study their influence on the biological activity. Several alkylamino or alkyloxy groups were also considered to replace the methylamine of our first generation of Imiqualines. Imidazo[1,2-a]pyrazine derivatives were also designed as potential minimal structure. The investigation on A375 melanoma cells displayed interesting in vitro low nanomolar cytotoxic activity. Among them, 9d (EAPB02303) is particularly remarkable since it is 20 times more potent than vemurafenib, the reference clinical therapy used on BRAF mutant melanoma. Contrary to the first generation, EAPB02303 does not inhibit tubulin polymerization, as confirmed by an in vitro assay and a molecular modelisation study. The mechanism of action for EAPB02303 highlighted by a transcriptomic analysis is clearly different from a panel of 12 well-known anticancer drugs. In vivoEAPB02303 treatment reduced tumor size and weight of the A375 human melanoma xenografts in a dose-dependent manner, correlated with a low mitotic index but not with necrosis.
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Affiliation(s)
- Cindy Patinote
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, Faculté de Pharmacie, 15 avenue Charles Flahault, BP 14491, 34093, Montpellier Cedex 5, France; Société d'Accélération du Transfert de Technologies (SATT AxLR), CSU, 950 rue Saint Priest, 34090, Montpellier, France
| | - Carine Deleuze-Masquéfa
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, Faculté de Pharmacie, 15 avenue Charles Flahault, BP 14491, 34093, Montpellier Cedex 5, France.
| | - Kamel Hadj Kaddour
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, Faculté de Pharmacie, 15 avenue Charles Flahault, BP 14491, 34093, Montpellier Cedex 5, France
| | - Laure-Anaïs Vincent
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, Faculté de Pharmacie, 15 avenue Charles Flahault, BP 14491, 34093, Montpellier Cedex 5, France
| | - Romain Larive
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, Faculté de Pharmacie, 15 avenue Charles Flahault, BP 14491, 34093, Montpellier Cedex 5, France
| | - Zahraa Zghaib
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, Faculté de Pharmacie, 15 avenue Charles Flahault, BP 14491, 34093, Montpellier Cedex 5, France; Tumorigenèse et Pharmacologie Antitumorale, Lebanese University, EDST, BP 90656, Fanar Jdeideh, Lebanon
| | - Jean-François Guichou
- CNRS, UMR 5048, INSERM, U105, Université de Montpellier, Centre de Biochimie Structurale, 34090, Montpellier, France
| | - Mona Diab Assaf
- Tumorigenèse et Pharmacologie Antitumorale, Lebanese University, EDST, BP 90656, Fanar Jdeideh, Lebanon
| | - Pierre Cuq
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, Faculté de Pharmacie, 15 avenue Charles Flahault, BP 14491, 34093, Montpellier Cedex 5, France
| | - Pierre-Antoine Bonnet
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, Faculté de Pharmacie, 15 avenue Charles Flahault, BP 14491, 34093, Montpellier Cedex 5, France
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Abstract
Please add expansion for AL. Melanoma is the most common fatal type of skin cancer and is an important and growing public health problem in the United States, Australia, New Zealand, and Europe. The mortality rate in most of the world has been rising as well, albeit slower than that for incidence. Likely due to the availability of new treatments for stage 4 melanoma, mortality rates in the United States dropped 18% from 2013 to 2016. We further describe trends in melanoma incidence and mortality, review the literature on risk factors, and provide an up-to-date assessment of population-wide screening and some of the inherent concerns.
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Affiliation(s)
- Nicole L Bolick
- Harvard T.H. Chan School of Public Health, Kresge Building Room 718, 677 Huntington Ave, Boston, MA 02115, USA; Department of Internal Medicine, East Carolina University/Vidant Medical Center, 600 Moye Boulevard, MA-350, Greenville, NC 27834, USA
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Kresge Building, Room 718, 677 Huntington Avenue, Boston, MA 02115, USA.
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In silico evaluation of some 4-(quinolin-2-yl)pyrimidin-2-amine derivatives as potent V600E-BRAF inhibitors with pharmacokinetics ADMET and drug-likeness predictions. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2020. [DOI: 10.1186/s43094-020-00084-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Abstract
Background
The resistance of V600E-BRAF to the vemurafenib and the side effects of the identified inhibitors trigger the research for a novel and more potent anti-melanoma agents. In this study, virtual docking screening along with pharmacokinetics ADMET and drug-likeness predictions were combined to evaluate some 4-(quinolin-2-yl)pyrimidin-2-amine derivatives as potent V600E-BRAF inhibitors.
Results
Some of the selected compounds exhibited better binding scores and favorable interaction with the V600E-BRAF enzyme. Out of the screened compounds, two most potent (5 and 9) having good Rerank scores (− 128.011 and − 126.258) emerged as effective and potent V600E-BRAF inhibitors that outperformed the FDA-approved V600E-BRAF inhibitor (vemurafenib, − 118.607). Thus, the molecular docking studies revealed that the studied compounds showed competing for inhibition of V600E-BRAF with vemurafenib at the binding site and possessed better pharmacological parameters based on the drug-likeness rules filters for the oral bioavailability, and ADMET risk parameters.
Conclusion
The docking analysis, drug-likeness rules filters, and ADMET study identified compounds (5 and 9) as the best hits against V600E-BRAF kinase with enhanced pharmacological properties. This recommends that these compounds may be developed as potent anti-melanoma agents.
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Bucchi L, Mancini S, Crocetti E, Dal Maso L, Baldacchini F, Vattiato R, Giuliani O, Ravaioli A, Caldarella A, Carrozzi G, Ferretti S, Filiberti RA, Fusco M, Gatti L, Gili A, Magoni M, Mangone L, Mazzoleni G, Michiara M, Panato C, Piffer S, Piras D, Rosso S, Rugge M, Scala U, Tagliabue G, Tumino R, Stanganelli I, Falcini F. Mid-term trends and recent birth-cohort-dependent changes in incidence rates of cutaneous malignant melanoma in Italy. Int J Cancer 2020; 148:835-844. [PMID: 33405292 DOI: 10.1002/ijc.33259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/21/2020] [Accepted: 07/28/2020] [Indexed: 01/12/2023]
Abstract
In Oceania, North America and north-western Europe, after decades of increase, cutaneous malignant melanoma (CMM) rates began to stabilise or decline before 2000. Anecdotal evidence suggests that the reversal of the incidence trend is extending to southern Europe. To obtain a formal confirmation, this nationwide study from Italy investigated the incidence trends by birth cohort. Twenty-one local cancer registries covering a population of 15 814 455 provided incidence data for primary CMM registered between 1994 and 2013. Trends in age-standardised rates were analysed using joinpoint regression models and age-period-cohort models. Age-standardised incidence showed a consistent increase throughout the period (estimated annual percent change, 3.6 [95% confidence interval, 3.2-4.0] among men and 2.5 [2.0-3.1] among women). This pattern was confirmed by a sensitivity analysis with removal of low-risk populations of southern Italy. The rates, however, showed a stabilisation or a decrease in men and women aged below 35. Using the cohort of 1949-the median cohort with respect to the number of cases for both genders-as a reference, the incidence rate ratio increased for successive cohorts born until 1973 (women) and 1975 (men), and subsequently tended to decline. For the most recent cohorts in both genders, the risk of disease returned to the level of the cohort of 1949. The changes observed in the latest generations can be interpreted as the earliest manifestations of a birth-cohort-dependent incidence decrease. Our study adds to previous data indicating that the reversal of the long-term upward incidence trend of CMM is extending to southern Europe.
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Affiliation(s)
- Lauro Bucchi
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Silvia Mancini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Emanuele Crocetti
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Rosa Vattiato
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Giuliano Carrozzi
- Modena Cancer Registry, Public Health Department, Local Health Authority, Modena, Italy
| | - Stefano Ferretti
- Romagna Cancer Registry, section of Ferrara, Local Health Authority, and University of Ferrara, Ferrara, Italy
| | | | | | - Luciana Gatti
- Mantova Cancer Registry, Epidemiology Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, Mantova, Italy
| | - Alessio Gili
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Michele Magoni
- Registry of Brescia Province, Epidemiology Unit, Brescia Health Protection Agency, Brescia, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - Daniela Piras
- Sassari Cancer Registry, Azienda Regionale per la Tutela della Salute - ATS, Sassari, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Giovanna Tagliabue
- Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), Ragusa, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy.,Department of Dermatology, University of Parma, Parma, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy.,Cancer Prevention Unit, Local Health Authority, Forlì, Italy
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Chao X, Jia Y, Feng X, Wang G, Wang X, Shi H, Zhao F, Jiang C. A Case-Control Study of ADCY9 Gene Polymorphisms and the Risk of Hepatocellular Carcinoma in the Chinese Han Population. Front Oncol 2020; 10:1450. [PMID: 32983975 PMCID: PMC7477943 DOI: 10.3389/fonc.2020.01450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/08/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Adenylyl cyclase type 9 (ADCY9) modulates signal transduction by producing the second messenger cyclic AMP. It has been reported that ADCY9 gene polymorphisms were associated with cancer development. The aim of this study was to investigate whether ADCY9 gene polymorphisms could contribute to the susceptibility of hepatocellular carcinoma (HCC) in the Chinese Han population. Methods: In the present study, five single-nucleotide polymorphisms (SNPs) in ADCY9 were genotyped using Agena MassARRAY platform in 876 subjects from China. Logistic regression was used to assess the effects of SNPs on HCC risk. Associations were also evaluated for HCC risk stratified by age and gender. False discovery rate (FDR) was used to correct multiple testing. Results: After adjusting for age and gender, we found a significant relationship between heterozygous genotypes of rs2531995 and HCC risk (OR = 1.34, 95% CI = 1.01–1.77, p = 0.045). ADCY9 rs2230742 had a strong relationship with lower risk of HCC in allele (p = 0.006), co-dominant (p = 0.023), dominant (p = 0.010), and additive (p = 0.006) models. Stratified analysis showed that rs879620 increased HCC risk and rs2230742 was associated with lower risk of HCC in the individuals aged 55 or younger, rs2531992 significantly decreased HCC risk in the elder group (age > 55). For women, rs2230742 and rs2230741 were significantly associated with HCC risk in multiple models (p < 0.05). FDR analysis showed that rs2230742 could protect individuals from HCC risk in the allele model (FDR-p = 0.030). In addition, haplotype analysis indicated that Crs879620Ars2230742Ars2230741 haplotype was a protective factor for HCC (OR = 0.67, 95% CI = 0.50–0.89, p = 0.007, FDR-p = 0.028). Conclusion: Our findings suggest that ADCY9 gene polymorphisms are associated with HCC risk in the Chinese Han population.
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Affiliation(s)
- Xu Chao
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China.,The Second Affiliated Hospital, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Yong Jia
- The Affiliated Hospital, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Xuesong Feng
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Guoquan Wang
- The College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Xiaoping Wang
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Hailong Shi
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Fei Zhao
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Chao Jiang
- Department of Neurology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, China
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Zlatarova ZI, Dokova KG. Incidence of Non-melanoma Eyelid Malignancies in Bulgaria (2000-2015). Ophthalmic Epidemiol 2020; 28:198-204. [PMID: 32811268 DOI: 10.1080/09286586.2020.1808230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Malignant eyelid tumours are the most common malignancies in ophthalmic practice. We report here the incidence of non-melanoma eyelid malignancies in Bulgaria, for the period 2000-2015. METHODS All cases coded with the International Classification of Diseases (ICD) code C 44.1, received from the Bulgarian National Cancer Registry, were used for estimating crude incidence rates by age and sex. In addition, directly age standardized incidence rates for non-melanoma eyelid malignancies are presented based on the European Standard population (year 2013) for Bulgaria and the region of Varna. RESULTS Over the 16-year period there were 3,046 cases in total, of which 1,457 (47.8%) were among men. The age standardized rate (ASR) of non-melanoma eyelid malignancies in men was 2.9 per 100,000 (95% CI 2.79-3.11), in women it was 2.4 per 100,000 (95% CI 2.30-2.54), and the mean ASR was 2.6 per 100,000 (95% CI 2.53-2.73) for both sexes during the period. The ASR increased for women and for both sexes combined.The risk of eyelid malignancies was higher for men than for women with RR of 1.21 (95% CI 1.08-1.41) during the whole period. The risk was higher in women up to the age of 55 and over 55 years it was higher in men. CONCLUSION We report results for the incidence of eyelid non-melanoma malignancies in a south-eastern European country, Bulgaria. They are comparable with earlier reports from other European countries.
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Affiliation(s)
| | - Klara Georgieva Dokova
- Department of Social Medicine and Health Care Organization, Medical University, Varna, Bulgaria
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Bianconi F, Crocetti E, Grisci C, Primieri C, Stracci F. What has changed in the epidemiology of skin melanoma in central Italy during the past 20 years? Melanoma Res 2020; 30:396-401. [PMID: 30480621 DOI: 10.1097/cmr.0000000000000551] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim was to evaluate changes in skin melanoma incidence and mortality at a population level in central Italy over the past two decades. Skin melanoma incidence rate from 1994 to 2014, were retrieved from the Umbrian Cancer Registry (about 900 000 inhabitants). Changes from 1994-1999 to 2010-2014 in tumour and patient characteristics - sex, age (0-44, 45-64, ≥ 65 years), site (head and neck, trunk, limbs), morphology (superficial spreading, nodular, other), thickness (≤ 1, 1-2, 2-4, > 4) and stage I-II, III-IV - were evaluated. Trends in age-standardized incidence and mortality rates were evaluated as annual percent change. During the past two decades, melanoma incidence significantly increased in both sexes (+6%/year among men and +4%/year among women) and in all ages (0-44 years: + 4.7 and + 4.3; 45-64 years: + 6.1 and + 4.4; ≥65 years: + 6.6 and + 1.7), morphologies, except nodular, and stages. Mortality was stable among men and women. In the area, incidence increased for thin and thick melanoma, showing a true increase, whereas mortality did not increase. Therefore, although improvements in treatment and downstaging effect of early diagnosis have to be considered, a certain degree of overdiagnosis cannot be ruled out.
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Affiliation(s)
| | - Emanuele Crocetti
- Romagna Cancer Registry, IRCCS Istituto scientifico romagnolo per lo studio e la cura dei tumori (IRST), Meldola, Forlì-Cesena
| | - Chiara Grisci
- School of Specialization in Hygiene and Preventive Medicine
| | | | - Fabrizio Stracci
- Umbria Cancer Registry, Umbria
- Department of Experimental Medicine, Public Health Section, University of Perugia, Perugia, Italy
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23
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Increasing melanoma incidence in the elderly in North-East Hungary: is this a more serious problem than we thought? Eur J Cancer Prev 2020; 28:544-550. [PMID: 30399042 DOI: 10.1097/cej.0000000000000489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
There is a great need for efficient and cost-effective melanoma screening, but this is not yet solved. Epidemiological studies on trends in melanoma incidence by tumour thickness, anatomical site and demographical data can help to improve public health efforts regarding earlier melanoma diagnosis. We aimed to study the trends in the incidence and characteristics of patients and their melanoma in North-East Hungary from 2000 to 2014. Data were obtained from a university hospital-based registry. A total of 1509 cutaneous invasive melanomas of 1464 patients were included in the study. A moderate but significant increase in incidence was observed in the region [average annual percentage change: 3.04 (0.07; 6.11); P = 0.045], with a breakpoint in 2007. From 2001 to 2007, the trend was increasing [APC: 9.84 (3.52; 16.55); P=0.006], but it stalled from 2007 [APC: -2.45 (-5.99; 1.23); P = 0.164]. However, in the age groups over the age of 60 years, where the standardised incidence was the highest, the incidence continued to rise. Furthermore, older age, male sex and trunk or lower extremity localization were found to be associated with thicker melanomas. Our results support that regular screening examination for melanoma would be desirable for people over the age of 60 years.
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Forsea AM. Melanoma Epidemiology and Early Detection in Europe: Diversity and Disparities. Dermatol Pract Concept 2020; 10:e2020033. [PMID: 32642304 PMCID: PMC7319793 DOI: 10.5826/dpc.1003a33] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2019] [Indexed: 12/24/2022] Open
Abstract
Melanoma claims annually more than 20,000 lives in Europe and is an important public health burden through its continuously increasing incidence and with its high mortality, costs, and complexity of care in advanced stages. Epidemiological surveillance is indispensable for the research into its causes, new prognostic markers, and innovative therapies, as well as for the building of efficient cancer control plans. However, important differences in the sources and availability of accurate epidemiological data exist among European countries and regions, contributing to a heterogeneous picture with 20-fold differences in the reported national melanoma incidence rates, divergent mortality trends, and solid disparities in survival across the Continent. Countries in the eastern half of Europe report the lowest incidence rates, but high case fatality, persisting and increasing mortality, a higher proportion of thicker tumors and late diagnosis, and lower survival rates. They are the least well equipped with quality cancer registration and reporting, and they lag behind in efficient cancer control plans implementation. This review highlights the main differences in melanoma epidemiology across Europe, together with an insight into their underlying causes in the areas of melanoma registration, early diagnosis, and prevention. These differences should be acknowledged and understood by physicians, researchers, and all stakeholders involved in improving melanoma care and outcomes, as no one-size-fits-all solution can tackle the melanoma problem in Europe. Instead, there is a need for nuanced strategies, adapted to the heterogeneous national and regional contexts, that would build on European diversity to eliminate the outcome disparities.
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Affiliation(s)
- Ana-Maria Forsea
- Oncologic Dermatology Department, Elias University Hospital; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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25
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Herbert A, Koo MM, Barclay ME, Greenberg DC, Abel GA, Levell NJ, Lyratzopoulos G. Stage-specific incidence trends of melanoma in an English region, 1996-2015: longitudinal analyses of population-based data. Melanoma Res 2020; 30:279-285. [PMID: 30106842 PMCID: PMC6330074 DOI: 10.1097/cmr.0000000000000489] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to examine temporal trends in overall and stage-specific incidence of melanoma. Using population-based data on patients diagnosed with melanoma in East Anglia, England, 1996-2015, we estimated age-standardized time trends in annual incidence rates for each stage at diagnosis. Negative binomial regression was used to model trends over time adjusted for sex, age group and deprivation, and to subsequently examine variation in stage-specific trends by sex and age group. The age-standardized incidence increased from 14 to 29 cases/100 000 persons (i.e. 4% annually). Increasing incidence was apparent across all stages but was steepest for stage I [adjusted annual increase: 5%, 95% confidence interval (CI): 5-6%, and more gradual for stage II-IV disease (stage II: 3%, 95% CI: 2-4%; stage III/IV: 2%, 95% CI: 1-3%)]. Stage II-IV increase was apparent in men across age groups and in women aged 50 years or older. Increases in incidence were steeper in those aged 70 years or older, and in men. The findings suggest that both a genuine increase in the incidence of consequential illness and a degree of overdiagnosis may be responsible for the observed increasing incidence trends in melanoma in our population during the study period. They also suggest the potentially lower effectiveness of public health awareness campaigns in men and older people.
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Affiliation(s)
- Annie Herbert
- Epidemiology of Cancer Healthcare & Outcomes (ECHO) research group, Department of Behavioural Sciences and Health, University College London, 1-19 Torrington Place, London, UK
| | - Minjoung M. Koo
- Epidemiology of Cancer Healthcare & Outcomes (ECHO) research group, Department of Behavioural Sciences and Health, University College London, 1-19 Torrington Place, London, UK
| | - Matthew E. Barclay
- Public Health England National Cancer Registration and Analysis Service, Victoria House, Capital Park, Fulbourn, Cambridge, UK
- Cambridge Centre for Health Services Research, University of Cambridge Institute of Public Health, Forvie Site, Cambridge, UK
| | - David C. Greenberg
- Public Health England National Cancer Registration and Analysis Service, Victoria House, Capital Park, Fulbourn, Cambridge, UK
- Cambridge Centre for Health Services Research, University of Cambridge Institute of Public Health, Forvie Site, Cambridge, UK
| | | | - Nick J. Levell
- Dermatology Department, Norfolk and Norwich University Hospital, Norwich, UK
| | - Georgios Lyratzopoulos
- Epidemiology of Cancer Healthcare & Outcomes (ECHO) research group, Department of Behavioural Sciences and Health, University College London, 1-19 Torrington Place, London, UK
- Public Health England National Cancer Registration and Analysis Service, Victoria House, Capital Park, Fulbourn, Cambridge, UK
- Cambridge Centre for Health Services Research, University of Cambridge Institute of Public Health, Forvie Site, Cambridge, UK
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Yang DD, Salciccioli JD, Marshall DC, Sheri A, Shalhoub J. Trends in malignant melanoma mortality in 31 countries from 1985 to 2015. Br J Dermatol 2020; 183:1056-1064. [PMID: 32133614 DOI: 10.1111/bjd.19010] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Malignant melanoma (MM) causes the highest absolute number of deaths among skin cancers. An up-to-date analysis of international MM mortality trends is required for assessing the burden of disease, and may support the assessment of the effectiveness of new diagnostic, therapeutic and preventative strategies. OBJECTIVES To report MM mortality trends between 1985 and 2015 using the World Health Organization (WHO) Mortality Database. MATERIALS AND METHODS We used country-level MM mortality data from the WHO Mortality Database for all countries with high usability death registration data. Mortality trends were described using Joinpoint regression modelling. RESULTS Thirty-one countries met the inclusion criteria. All countries, except the Czech Republic, demonstrated increased age-standardized death rates (ASDRs) in males over the observation period. More countries exhibited decreased or stable MM mortality in females. The median mortality rate for 2013-2015 was 2·57 deaths per 100 000 for males and 1·55 per 100 000 for females. Australia and Norway had the highest ASDRs for males (5·72 per 100 000 and 4·55 per 100 000, respectively). Norway and Slovenia had the highest ASDRs for females (3·02 per 100 000 and 2·58 per 100 000, respectively). MM mortality was greater for males than females in all countries, with sex disparity increasing across the period. Disparity in mortality between older and younger cohorts in several countries was also found. CONCLUSIONS An overall increase in MM mortality over the past 30 years was observed. However, there was notable variation in mortality trends between countries, as well as between males and females, and between different age groups.
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Affiliation(s)
- D D Yang
- North Central and East London Foundation School, London, UK
| | - J D Salciccioli
- Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA
| | - D C Marshall
- Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - A Sheri
- Department of Oncology, Royal Free London NHS Foundation Trust, London, UK
| | - J Shalhoub
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
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Loria D, Abriata MG, Santoro F, Latorre C. Cutaneous melanoma in Argentina: an analysis of its characteristics and regional differences. Ecancermedicalscience 2020; 14:1017. [PMID: 32256700 PMCID: PMC7105344 DOI: 10.3332/ecancer.2020.1017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose This study aims to increase the knowledge about the characteristics of cutaneous melanoma in Argentina, their association with the risk of having Breslow ≥1 mm and mortality trends for the period 2002-2017. Patients and methods Descriptive statistics and regression analyses were done for 10.199 cases within the Argentine Melanoma Registry in the period 2002-2018. Trends in age-standardised mortality rates (ASMR) were analysed using the Join point Regression Model. Results Cases showed lesions mainly located in males' trunk (37%) and in females' lower limbs (29%). The level of invasion was higher in males who also showed higher mortality. Cases from the North West and North East regions showed a major risk of Breslow >1 mm and harboured CM in lower limbs more frequently than in other regions. Nearly, 25% of tumours over 2 mm were in cases aged <50 years and 37.6% in patients ≥50 years. In the North West, North East and Patagonia, the frequency of cases in young people was higher than in older people. In 43% of cases, the melanoma subtype was not specified in the report. The number of superficial spreading melanomas, the most common histology, was nearly twice that of Nodular melanomas the following histology in importance (3,403 and 1,754, respectively). Melanoma mortality rates in all Argentine population increased in the elderly. Lower melanoma mortality rates were observed in the North West. In 2007-2017, ASMR decreased significantly in females (average 1.4% p/year) while it increased nonsignificantly in males (0.4% p/year).The tumours with the worst prognosis were associated with the elderly, males, nodular or acrolentiginous morphologies, residing somewhere other than Centro and Patagonia and with tumors located in the head/neck and legs. Conclusion The geographical variations found for melanoma characteristics and their mortality in Argentina, makes it imperative that epidemiological research is continued to avoid generalisations and improve future preventive actions.
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Affiliation(s)
- Dora Loria
- Argentine Registry of Cutaneous Melanoma, Av Callao 852, C1025 CABA, Argentina
| | | | - Federico Santoro
- Fellow of Epidemiology, National Ministry of Health, Av 9 de Julio 1925, C1072 CABA, Argentina
| | - Clara Latorre
- Argentine Registry of Cutaneous Melanoma, Av Callao 852, C1025 CABA, Argentina
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Abstract
Melanoma and keratinocyte skin cancer (KSC) are the most common types of cancer in White-skinned populations. Both tumor entities showed increasing incidence rates worldwide but stable or decreasing mortality rates. Rising incidence rates of cutaneous melanoma (CM) and KSC are largely attributed to increasing exposure to ultraviolet (UV) radiation, the main causal risk factor for skin cancer.Incidence rates of KSC, comprising of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are much higher than that of melanoma. BCC development is mainly the cause of an intensive UV exposure in childhood and adolescence, while SCC development is related to chronic, cumulative UV exposure over decades. Although mortality is relatively low, KSC is an increasing problem for health care services causing significant morbidity.Cutaneous melanoma is rapidly increasing in White populations, with an estimated annual increase of around 3-7% over the past decades. In contrast to SCC, melanoma risk is associated with intermittent and chronic exposure to sunlight. The frequency of its occurrence is closely associated with the constitutive color of the skin and the geographical zone. Changes in outdoor activities and exposure to sunlight during the past 70 years are an important factor for the increasing incidence of melanoma. Mortality rates of melanoma show stabilization in the USA, Australia, and in European countries. In the USA even dropping numbers of death cases were recently reported, probably reflecting efficacy of the new systemic treatments.Among younger cohorts in some populations (e.g., Australia and New Zealand,), stabilizing or declining incidence rates of CM are observed, potentially caused by primary prevention campaigns aimed at reducing UV exposure. In contrast, incidence rates of CM are still rising in most European countries and in the USA. Ongoing trends towards thinner melanoma are largely ascribed to earlier detection.
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Gutiérrez-González E, López-Abente G, Aragonés N, Pollán M, Pastor-Barriuso R, Sánchez MJ, Pérez-Gómez B. Trends in mortality from cutaneous malignant melanoma in Spain (1982-2016): sex-specific age-cohort-period effects. J Eur Acad Dermatol Venereol 2019; 33:1522-1528. [PMID: 30868690 DOI: 10.1111/jdv.15565] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/25/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Mortality from malignant cutaneous melanoma increased alarmingly during the second half of the 20th century in Spain and other European countries. OBJECTIVE The aim was to analyse sex- and age-specific trends in melanoma mortality in Spain in the period 1982-2016. METHODS European age-standardized melanoma mortality rates during the period 1982-2016 were calculated from mortality figures provided by the National Statistics Institute. Joinpoint regressions were used to identify significant points of change in trends and to compute average annual per cent change (AAPC). Age-cohort-period models were fitted to explore the effect of these variables on mortality. RESULTS During the period 1982-2016, age-standardized melanoma mortality rates increased in Spain from 0.90 to 1.80 deaths per 100 000 people in men and from 0.64 to 1.11 per 100 000 in women, rising noticeably from 1982 to 1995 in both sexes and in all age groups. From the mid-90s different trends were observed depending on sex and age: there was a decrease in mortality in the population younger than 45 years (AAPC -2 in both sexes) and aged 45-64 years (AAPC -1 among men and -0.2 among women), but in the group over 64 years rates continued to increase (AAPC 1.7 and 0.2, respectively, for men and women). The mortality sex ratio decreased in the younger population but increased in older individuals. A cohort effect was observed with lower mortality in the cohorts born after 1943 in men and 1956 in women. There was also a period effect with decreased mortality rates at the beginning of the 1990s. CONCLUSIONS Melanoma mortality rates in Spain increased during the last decades of the 20th century; however, later they stabilized in women and began to decrease in younger cohorts and middle-aged men. Promotion of primary and secondary prevention measures should continue, with particular emphasis on males over 65 years.
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Affiliation(s)
- E Gutiérrez-González
- Public Health & Preventive Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - G López-Abente
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - N Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - M Pollán
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - R Pastor-Barriuso
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - M J Sánchez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria (ibs.GRANADA), University of Granada, Granada, Spain
| | - B Pérez-Gómez
- Public Health & Preventive Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cardiovascular & Metabolic Diseases Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
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30
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Skiljevic D, Sreckovic L. Ultraviolet radiation exposure among Belgrade high school students: analysis of knowledge, attitudes and behaviour. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:63-75. [PMID: 30811695 DOI: 10.1111/jdv.15312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND The incidence of melanoma has been increasing worldwide. Extended UV exposure during childhood or adolescence significantly increases the probability of skin cancer in adulthood. OBJECTIVE The objective of this study was to analyse knowledge, attitudes and behaviour regarding exposure to natural and artificial UV radiation among Belgrade high school students. METHODS The study was conducted using a questionnaire among 549 students of 3rd and 4th grade (17 and 18 years of age) in four Belgrade high schools. The questionnaire had 32 questions: questions about gender, date and month of birth and parents' education, nine questions regarding sunbed use, nine questions regarding behaviour in the sun during summer months, four questions regarding personal and family history and skin phototype and seven questions regarding attitude and general knowledge about effects of UV radiation. Assessment of frequency rate and relative numbers was used as methods of descriptive statistics. RESULTS As many as 39% of participants had used a sunbed at least once, 38% plan on using it in the future. One quarter spends more than 3 hours in the sun on the beach during summer without any protection, and only one-third of participants had not experienced sunburn during last summer. Only one-half of students know what melanoma is, while 37% stated that they do not know. CONCLUSION General awareness of risk factors regarding sun exposure as well as general knowledge about melanoma is not on a high level among Belgrade high school students. Therefore, besides legislative measures, it is extremely important to conduct adequate education programmes in high schools.
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Affiliation(s)
- D Skiljevic
- Clinic of Dermatovenereology, Clinical Centre of Serbia, Belgrade, Serbia.,Department of Dermatovenereology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - L Sreckovic
- Clinic of Dermatovenereology, Clinical Centre of Serbia, Belgrade, Serbia
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31
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Santos CAD, Souza DLB. Melanoma mortality in Brazil: trends and projections (1998-2032). CIENCIA & SAUDE COLETIVA 2019; 24:1551-1561. [PMID: 31066856 DOI: 10.1590/1413-81232018244.13932017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/18/2017] [Indexed: 02/06/2023] Open
Abstract
Melanoma is the main serious skin cancer, due to its high lethality. This study aimed to make projections and analyze melanoma mortality trends in Brazil. Mortality Information System data were utilized for the period 1998-2012, which were projected until 2032, using the age-period-cohort model, with software R. The analysis of trends was made by Joinpoint regression, with 95% confidence interval, estimating the annual percentage change. It was revealed higher amounts of deaths in men for all regions. Brazilian trends presented reductions in men (APC = -0.4; CI95% = -0.6; -0.1; p < 0.01) and in women (APC = -0.8; CI95% = -0.9; -0.7; p < 0.01). The Midwest region presented increases for both sexes, while the Southeast region presented reducing trends for both sexes. In the North, there was stability for men and increases followed by stability in women, while the South presented reductions in men and stability in women; finally, the Northeast revealed one joinpoint per sex, with an increase followed by stability in men, and stability followed by reducing trends in women. The highest rates of the country were found in the South and Southeast regions, however, with reducing trends throughout time. Higher mortality trends in men were associated with later diagnoses in this group.
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Affiliation(s)
- Camila Alves Dos Santos
- Departamento de Saúde Coletiva e Nutrição , Centro de Ciências da Saúde , Universidade Federal do Rio Grande do Norte . Av. Sen. Salgado Filho, Lagoa Nova. 59078-970 Natal RN Brasil .
| | - Dyego Leandro Bezerra Souza
- Departamento de Saúde Coletiva e Nutrição , Centro de Ciências da Saúde , Universidade Federal do Rio Grande do Norte . Av. Sen. Salgado Filho, Lagoa Nova. 59078-970 Natal RN Brasil .
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32
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Garbe C, Keim U, Eigentler TK, Amaral T, Katalinic A, Holleczek B, Martus P, Leiter U. Time trends in incidence and mortality of cutaneous melanoma in Germany. J Eur Acad Dermatol Venereol 2019; 33:1272-1280. [DOI: 10.1111/jdv.15322] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 09/27/2018] [Indexed: 01/11/2023]
Affiliation(s)
- C. Garbe
- Centre for Dermato‐Oncology Department of Dermatology Eberhard‐Karls University Tuebingen Germany
| | - U. Keim
- Centre for Dermato‐Oncology Department of Dermatology Eberhard‐Karls University Tuebingen Germany
| | - T. K. Eigentler
- Centre for Dermato‐Oncology Department of Dermatology Eberhard‐Karls University Tuebingen Germany
| | - T. Amaral
- Centre for Dermato‐Oncology Department of Dermatology Eberhard‐Karls University Tuebingen Germany
- Portuguese Air Force Health Care Direction Lisbon Portugal
| | - A. Katalinic
- Institute of Social Medicine and Epidemiology University Hospital Schleswig‐Holstein Luebeck Germany
| | | | - P. Martus
- Institute for Clinical Epidemiology und Applied Biostatistics Eberhard‐Karls University Tuebingen Germany
| | - U. Leiter
- Centre for Dermato‐Oncology Department of Dermatology Eberhard‐Karls University Tuebingen Germany
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33
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Rotaru M, Jitian CR, Iancu GM. A 10-year retrospective study of melanoma stage at diagnosis in the academic emergency hospital of Sibiu county. Oncol Lett 2019; 17:4145-4148. [PMID: 30944608 DOI: 10.3892/ol.2019.10098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/28/2019] [Indexed: 01/18/2023] Open
Abstract
Melanoma is considered to be the most aggressive skin cancer, with an increasing incidence worldwide. An accurate staging of melanoma is crucial in describing the cancer status, estimating prognosis and deciding the optimal treatment solution. In the present study, melanoma staging highlights the importance of early detection, most of the patients having been diagnosed with advanced stages of this skin cancer. A retrospective study was conducted among 117 patients of the Academic Emergency County Hospital of Sibiu, diagnosed with melanoma between 2007 and 2016. The staging of the patients with melanoma was made using the American Joint Committee on Cancer (AJCC) 7th edition, and reconsidered in the light of the AJCC 8th edition. The results showed that the majority of the cases had distant metastases, 40.17% were diagnosed with stage IV melanoma. 25.65% of the patients were diagnosed with stage III melanoma, having a regional disease. The rest of the cases had localized melanoma (stages I and II, 30.76%), while only 3.42% of them were diagnosed with melanoma in situ, the melanoma type with the greatest chances of survival. Analyzing the Breslow index, it was observed that the most common tumor thickness was 2.1 to 4 mm (34.19%). In conclusion, as the incidence of melanoma increases in Romania, further efforts are needed to improve the early detection of melanoma. There are hopes that with the correct and early diagnosis of melanoma, the mortality rate of this neoplasm will decrease in the future.
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Affiliation(s)
- Maria Rotaru
- Department of Dermatology, Faculty of Medicine, 'Lucian Blaga' University of Sibiu, 550245 Sibiu, Romania.,Clinic of Dermatology, Clinical Hospital of Sibiu, 550245 Sibiu, Romania
| | | | - Gabriela Mariana Iancu
- Department of Dermatology, Faculty of Medicine, 'Lucian Blaga' University of Sibiu, 550245 Sibiu, Romania.,Clinic of Dermatology, Clinical Hospital of Sibiu, 550245 Sibiu, Romania
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Kandolf Sekulovic L, Guo J, Agarwala S, Hauschild A, McArthur G, Cinat G, Wainstein A, Caglevic C, Lorigan P, Gogas H, Alvarez M, Duncombe R, Lebbe C, Peris K, Rutkowski P, Stratigos A, Forsea AM, De La Cruz Merino L, Kukushkina M, Dummer R, Hoeller C, Gorry C, Bastholt L, Herceg D, Neyns B, Vieira R, Arenberger P, Bylaite-Bucinskiene M, Babovic N, Banjin M, Putnik K, Todorovic V, Kirov K, Ocvirk J, Zhukavets A, Ymeri A, Stojkovski I, Garbe C. Access to innovative medicines for metastatic melanoma worldwide: Melanoma World Society and European Association of Dermato-oncology survey in 34 countries. Eur J Cancer 2018; 104:201-209. [PMID: 30388700 DOI: 10.1016/j.ejca.2018.09.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 09/12/2018] [Indexed: 12/19/2022]
Abstract
According to data from recent studies from Europe, a large percentage of patients have restricted access to innovative medicines for metastatic melanoma. Melanoma World Society and European Association of Dermato-oncology conducted a Web-based survey on access to first-line recommended treatments for metastatic melanoma by current guidelines (National Comprehensive Center Network, European Society for Medical Oncology [ESMO] and European Organization for Research and Treatment of Cancer/European Association of Dermato-oncology/European dermatology Forum) among melanoma experts from 27 European countries, USA, China, Australia, Argentina, Brazil, Chile and Mexico from September 1st, 2017 to July 1st, 2018. Data on licencing and reimbursement of medicines and the number of patient treated were correlated with the data on health expenditure per capita (HEPC), Mackenbach score of health policy performance, health technology assessment (HTA), ASCO and ESMO Magnitude of clinical benefit scale (ESMO MCBS) scores of clinical benefit and market price of medicines. Regression analysis for evaluation of correlation between the parameters was carried out using SPSS software. The estimated number of patients without access in surveyed countries was 13768. The recommended BRAFi + MEKi combination and anti-PD1 immunotherapy were fully reimbursed/covered in 19 of 34 (55.8%) and 17 of 34 (50%) countries, and combination anti-CTLA4+anti-PD1 in was fully covered in 6 of 34 (17.6%) countries. Median delay in reimbursement was 991 days, and it was in significant correlation with ESMO MCBS (p = 0.02), median market price (p = 0.001), HEPC and Mackenbach scores (p < 0.01). Price negotiations or managed entry agreements (MEAs) with national authorities were necessary for reimbursement. In conclusion, great discrepancy exists in metastatic melanoma treatment globally. Access to innovative medicines is in correlation with economic parameters as well as with healthcare system performance parameters. Patient-oriented drug development, market access and reimbursement pathways must be urgently found.
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Affiliation(s)
- L Kandolf Sekulovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
| | - J Guo
- Department of Urology and Melanoma, Peking University Cancer Hospital & Institute, Beijing, PR China
| | - S Agarwala
- St. Luke's University Hospital and Temple University, Bethlehem, USA
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - G McArthur
- Divisions of Research and Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - G Cinat
- Médica Oncóloga Instituto de Oncología Angel Roffo, Universidad de Buenos Aires Fundación CIDEA, Buenos Aires, Argentina
| | - A Wainstein
- Institute of Post-graduation, Faculdade de Ciências Médicas de Minas Gerais (FCM-MG) - Belo Horizonte (MG), Brazil
| | - C Caglevic
- Medical Oncology Service, Oncology Department, Clinica Alemana Santiago, Faculty of Medicine Clinica Alemana-Universidad Del Desarrollo, Santiago, Chile
| | - P Lorigan
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
| | - H Gogas
- 1(st)Department of Internal Medicine, Laiko Hospital and 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - M Alvarez
- Medico en Instituto Nacional de Cancerologia, Mexico City Area, Mexico
| | - R Duncombe
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
| | - C Lebbe
- APHP Dermatology Department, University Paris 7 Diderot, INSERM U976, PARIS, France
| | - K Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - P Rutkowski
- Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - A Stratigos
- 1(st)Department of Internal Medicine, Laiko Hospital and 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A-M Forsea
- Carol Davila University of Medicine and Pharmacy, Elias University Hospital Bucharest, Romania
| | - L De La Cruz Merino
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - R Dummer
- UniversitätsSpital Zürich-Skin Cancer Center, University Hospital, Zürich, Switzerland
| | - C Hoeller
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Gorry
- National Centre for Pharmacoeconomics, Old Stone Building, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
| | - L Bastholt
- Department of Oncology, Odense University Hospital, Denmark
| | - D Herceg
- Department of Oncology, University Hospital Zagreb, Croatia
| | - B Neyns
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - R Vieira
- Department of Dermatology, Medical Faculty, University of Coimbra, Portugal
| | - P Arenberger
- Department of Dermatovenereology, Charles University 3rd Faculty of Medicine and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | | | - N Babovic
- Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - M Banjin
- Department of Oncology, University Hospital Sarajevo, Bosnia and Herzegovina
| | - K Putnik
- North Estonia Medical Centre, Tallinn, Estonia
| | - V Todorovic
- Clinic for Oncology and Radiotherapy, Podgorica, Montenegro
| | - K Kirov
- Clinic of Oncodermatology, National Cancer Center, Sofia, Bulgaria
| | - J Ocvirk
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - A Zhukavets
- Belarusian Medical Academy of Postgraduate Education (BelMAPE), Minsk, Belarus
| | - A Ymeri
- University Hospital Mother Theresa, Tirana, Albania
| | - I Stojkovski
- University Clinic of Radiotherapy and Oncology, Skopje, Macedonia
| | - C Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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35
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Göl İ, Erkin Ö. Knowledge and practices of primary care providers on skin cancer and skin self-examination. Rev Esc Enferm USP 2018; 52:e03359. [PMID: 30304199 DOI: 10.1590/s1980-220x2017039703359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 02/27/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the knowledge and practices related to skin cancer and skin self-examination of primary care providers. METHOD This cross-sectional descriptive study was conducted in Turkey. The study was carried out in primary health centers such as family health centers, community health centers, early cancer detection centers and family planning centers in 2016-2017. Participants' socio-demographic characteristics, their knowledge and practices related to skin cancer, skin cancer risk factors and skin self-examination were determined. RESULTS The study population included 94 primary care providers. The symptoms of which the participants were most aware were changes in the color of moles or skin spots (95.71%), and of which participants were the least aware was the itching of a mole (71.43%). Among participants, the most recognized risk factor was having fair skin (97.14%), whereas the least known was the presence of birthmarks (24.29%). The mean scores the participants obtained from the questionnaire were as follows: 5.39±1.61 for skin cancer risk factors and 10.47±2.73 for skin cancer symptoms. Of the participants, 14.29% received training on skin self-examination, 38.57% knew how to perform skin self-examination, and 67.14% did not perform skin self-examination. Of the participants, 61.7% did not perform skin self-examination because they did not know what to look for. Of the participants, 85.71% did not have continuing education/workshop about skin self-examination after graduation. CONCLUSION Although the primary care providers' knowledge of skin cancer symptoms was adequate, their knowledge of skin cancer risk factors was not sufficient. Primary care providers' knowledge of skin self-examination was good, but they did not perform skin self-examination adequately.
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Affiliation(s)
- İlknur Göl
- Çankırı Karatekin University, Faculty of Health Sciences, Department of Public Health Nursing, Çankırı, Turkey
| | - Özüm Erkin
- Ege University, Faculty of Nursing, Department of Public Health Nursing, İzmir, Turkey
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36
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Cayuela A, Cayuela L, Rodríguez-Domínguez S, Lorente A, Rodríguez de la Borbolla M. Is melanoma mortality declining in Spain? Analysis of trends from 1975 to 2016. Br J Dermatol 2018; 179:991-992. [DOI: 10.1111/bjd.16777] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Cayuela
- South Seville Health Management Area - 1; Unit of Public Health, Prevention and Health Promotion; Hospital de Valme; Seville Spain
| | - L. Cayuela
- Universidad de Sevilla Facultad de Medicina; Sevilla Andalucía Spain
| | | | - A.I. Lorente
- Department of Dermatology; Hospital Universitario de Valme; Sevilla Andalucía Spain
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Cutaneous Melanoma-A Long Road from Experimental Models to Clinical Outcome: A Review. Int J Mol Sci 2018; 19:ijms19061566. [PMID: 29795011 PMCID: PMC6032347 DOI: 10.3390/ijms19061566] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/21/2018] [Accepted: 05/22/2018] [Indexed: 02/07/2023] Open
Abstract
Cutaneous melanoma is a complex disorder characterized by an elevated degree of heterogeneity, features that place it among the most aggressive types of cancer. Although significant progress was recorded in both the understanding of melanoma biology and genetics, and in therapeutic approaches, this malignancy still represents a major problem worldwide due to its high incidence and the lack of a curative treatment for advanced stages. This review offers a survey of the most recent information available regarding the melanoma epidemiology, etiology, and genetic profile. Also discussed was the topic of cutaneous melanoma murine models outlining the role of these models in understanding the molecular pathways involved in melanoma initiation, progression, and metastasis.
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38
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Is the frequency of primary cutaneous melanoma increasing in Turkey? An evaluation of the experiences of two dermatology centers. JOURNAL OF ONCOLOGICAL SCIENCES 2018. [DOI: 10.1016/j.jons.2017.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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39
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Sacchetto L, Zanetti R, Comber H, Bouchardy C, Brewster DH, Broganelli P, Chirlaque MD, Coza D, Galceran J, Gavin A, Hackl M, Katalinic A, Larønningen S, Louwman MWJ, Morgan E, Robsahm TE, Sanchez MJ, Tryggvadóttir L, Tumino R, Van Eycken E, Vernon S, Zadnik V, Rosso S. Trends in incidence of thick, thin and in situ melanoma in Europe. Eur J Cancer 2018; 92:108-118. [PMID: 29395684 DOI: 10.1016/j.ejca.2017.12.024] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/14/2017] [Accepted: 12/21/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND We analysed trends in incidence for in situ and invasive melanoma in some European countries during the period 1995-2012, stratifying for lesion thickness. MATERIAL AND METHODS Individual anonymised data from population-based European cancer registries (CRs) were collected and combined in a common database, including information on age, sex, year of diagnosis, histological type, tumour location, behaviour (invasive, in situ) and lesion thickness. Mortality data were retrieved from the publicly available World Health Organization database. RESULTS Our database covered a population of over 117 million inhabitants and included about 415,000 skin lesions, recorded by 18 European CRs (7 of them with national coverage). During the 1995-2012 period, we observed a statistically significant increase in incidence for both invasive (average annual percent change (AAPC) 4.0% men; 3.0% women) and in situ (AAPC 7.7% men; 6.2% women) cases. DISCUSSION The increase in invasive lesions seemed mainly driven by thin melanomas (AAPC 10% men; 8.3% women). The incidence of thick melanomas also increased, although more slowly in recent years. Correction for lesions of unknown thickness enhanced the differences between thin and thick cases and flattened the trends. Incidence trends varied considerably across registries, but only Netherlands presented a marked increase above the boundaries of a funnel plot that weighted estimates by their precision. Mortality from invasive melanoma has continued to increase in Norway, Iceland (but only for elder people), the Netherlands and Slovenia.
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Affiliation(s)
- L Sacchetto
- Piedmont Cancer Registry, A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy; Politecnico di Torino, Turin, Italy; Università degli Studi di Torino, Turin, Italy.
| | - R Zanetti
- Piedmont Cancer Registry, A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy
| | - H Comber
- National Cancer Registry Ireland, Ireland
| | | | | | - P Broganelli
- A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy
| | - M D Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, CIBERESP, Spain
| | - D Coza
- Cluj Regional Cancer Registry, Oncology Institute Cluj, Romania
| | - J Galceran
- Tarragona Cancer Registry, Foundation Society for Cancer Research and Prevention, (FUNCA), Pere Virgili Health Research Institute (IISPV), Reus, Spain
| | - A Gavin
- Northern Ireland Cancer Registry, Queens University Belfast, Belfast, UK
| | - M Hackl
- Austrian National Cancer Registry, Wien, Austria
| | - A Katalinic
- Institute for Social Medicine and Epidemiology, University Lübeck, Lubeck, Germany
| | - S Larønningen
- Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | - M W J Louwman
- Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - E Morgan
- Northern Ireland Cancer Registry, Queens University Belfast, Belfast, UK
| | - T E Robsahm
- Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | - M J Sanchez
- Escuela Andaluza de Salud Pública, CIBER de Epidemiología y Salud Pública, (CIBERESP), Ibs, Granada, Spain
| | - L Tryggvadóttir
- Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland
| | - R Tumino
- Cancer Registry and Histopathology Department, "Civic - M.P.Arezzo" Hospital, ASP, Ragusa, Italy
| | | | - S Vernon
- National Cancer Registration Service - Public Health England, Cambridge, UK
| | - V Zadnik
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - S Rosso
- Piedmont Cancer Registry, A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy
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Barbaric J, Laversanne M, Znaor A. Malignant melanoma incidence trends in a Mediterranean population following socioeconomic transition and war: results of age-period-cohort analysis in Croatia, 1989-2013. Melanoma Res 2017; 27:498-502. [PMID: 28800032 DOI: 10.1097/cmr.0000000000000385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The aim of this study was to analyse trends of malignant melanoma incidence in Croatia for men and women of different age groups by birth cohorts and time periods, and to interpret them in the context of national socioeconomic changes over time and the possible implications for future prevention in South-Eastern European postcommunist countries with high mortality rates. We used the Croatian National Cancer Registry data to analyse incidence trends of malignant melanoma of the skin (ICD-9 code 172 and ICD-10 code C43) in men and women aged 25-79 years by age-period-cohort modelling. Over the 25-year period, the incidence was increasing by 5.0% annually in men and 4.6% in women. The age-period model provided the best fit for data in both sexes, with steeply increasing incidence rates, followed by a stabilization after the 2000s. On the cohort scale, incidence rates increased in successive generations of men, whereas in women, the risk of malignant melanoma attenuated in recent cohorts. Even if some progress has been achieved in recent years, the increasing melanoma incidence without concomitant declines in mortality would indicate a need to rekindle prevention efforts in the country taking the specific socioeconomic context into account.
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Affiliation(s)
- Jelena Barbaric
- aAndrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia bSection of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Şuteu O, Blaga ML, Nicula F, Şuteu P, Coza O, Achimaş-Cadariu P, Coza D. Incidence trends and survival of skin melanoma and squamous cell carcinoma in Cluj County, Romania. Eur J Cancer Prev 2017; 26 Joining forces for better cancer registration in Europe:S176-S182. [PMID: 28914690 DOI: 10.1097/cej.0000000000000382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The aim of this study was to determine the incidence trends of cutaneous melanoma (CM) and squamous cell carcinoma (SCC) in Cluj County, from 1998 to 2011, and the 5-year net survival between 2006 and 2010. Data on all cases of CM and SCC between 1998 and 2011 were obtained from Cluj Cancer Registry. Incidence rates were age standardized by the direct method Age Standardized Incidence Rate (ASIR), using the world standard population. Trends and annual percentage change (APC) of incidence rates were calculated by joinpoint regression analysis. The Pohar-Perme estimator was used to examine the 5-year net survival of cases diagnosed during 2006-2010 and followed up until December 2015. A total of 580 cases of CM and 397 cases of SCC were reported. During 1998-2011, the ASIR of CM increased significantly by 7.8% APC in male patients and by 7.42% APC in female patients, and the ASIR for SCC increased by 9.40% APC in male patients. In female patients, the incidence of SCC increased by 12.65% APC during 2002-2011. The 5-year net survival during 2006-2010 was 0.64 in men and 0.75 in women for CM and 0.86 and 1.00, respectively, for SCC. Survival rates showed an improving trend during 2006-2010, and were generally lower in men. Survival from both entities decreased with age and was lower in rural areas and in advanced stages in both sexes. This study reveals a rising incidence of cutaneous cancers in concordance with international trends. These data support the important role of primary and secondary prevention of skin cancers, focusing not only on melanoma, due to its lower survival, but also on SCC, in order to reduce their burden.
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Affiliation(s)
- Ofelia Şuteu
- aThe Oncology Institute "Prof. Dr. Ion Chiricuţă" b"Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Augustin M, Eissing L, Elsner P, Strömer K, Schäfer I, Enk A, Reusch M, Kaufmann R. Perception and image of dermatology in the German general population 2002-2014. J Eur Acad Dermatol Venereol 2017; 31:2124-2130. [DOI: 10.1111/jdv.14476] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 06/26/2017] [Indexed: 12/01/2022]
Affiliation(s)
- M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - L. Eissing
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - P. Elsner
- Department of Dermatology; Jena University Hospital; Jena Germany
| | - K. Strömer
- Dermatology Practice Mönchengladbach; Mönchengladbach Germany
| | - I. Schäfer
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - A. Enk
- Department of Dermatology; Heidelberg University Hospital; Heidelberg Germany
| | - M. Reusch
- Tibarg Dermatology Group Practice; Hamburg Germany
| | - R. Kaufmann
- Clinic for Dermatology, Venereology and Allergology; Frankfurt University; Frankfurt am Main Germany
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More than 5000 patients with metastatic melanoma in Europe per year do not have access to recommended first-line innovative treatments. Eur J Cancer 2017; 75:313-322. [DOI: 10.1016/j.ejca.2017.01.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 01/21/2017] [Indexed: 12/31/2022]
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Chen L, Jin S. Trends in mortality rates of cutaneous melanoma in East Asian populations. PeerJ 2016; 4:e2809. [PMID: 28028475 PMCID: PMC5182992 DOI: 10.7717/peerj.2809] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 11/20/2016] [Indexed: 11/20/2022] Open
Abstract
The incidence of cutaneous melanoma (CM) has rapidly increased over the past four decades. CM is often overlooked in East Asian populations due to its low incidence, despite East Asia making up 22% of the world’s population. Since the 1990s, Caucasian populations have seen a plateau in CM mortality rates; however, there is little data investigating the mortality rates of CM in East Asian populations. In this study, the World Health Organization Mortality Database with the joinpoint regression method, and a generalized additive model were used to investigate trends in age standardized mortality rates (ASMRs) of CM in four East Asia regions (Japan, Republic of Korea (Korea), China: Hong Kong (Hong Kong), and Singapore) over the past six decades. In addition, mortality rate ratios by different variables (i.e., sex, age group, and region) were analyzed. Our results showed ASMRs of CM in East Asia significantly increased non-linearly over the past six decades. The joinpoint regression method indicated women had greater annual percentage changes than men in Japan, Korea, and Hong Kong. Men had significantly greater mortality rate ratio (1.51, 95% CI [1.48–1.54]) than women. Mortality rate ratios in 30−59 and 60+ years were significant greater than in the 0−29 years. Compared to Hong Kong, mortality rate ratio was 0.72 (95% CI [0.70–0.74]) times, 0.73 (95% CI [0.70–0.75]) times, and 1.02 (95% CI [1.00–1.05]) times greater in Japan, Korea, and Singapore, respectively. Although there is limited research investigating CM mortality rates in East Asia, results from the present study indicate that there is a significant growth in the ASMRs of CM in East Asian populations, highlighting a need to raise awareness of CM in the general population.
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Affiliation(s)
- Ling Chen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Immunotherapy Institutes, Fujian Medical University, Fuzhou, China
| | - Shaofei Jin
- Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences , Changchun , China
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Forsea AM, Tschandl P, Del Marmol V, Zalaudek I, Soyer HP, Geller AC, Argenziano G. Factors driving the use of dermoscopy in Europe: a pan-European survey. Br J Dermatol 2016; 175:1329-1337. [PMID: 27469990 DOI: 10.1111/bjd.14895] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND When used correctly, dermoscopy is an essential tool for helping clinicians in the diagnosis of skin diseases and the early detection of skin cancers. Despite its proven benefits, there is a lack of data about how European dermatologists use dermoscopy in everyday practice. OBJECTIVES To identify the motivations, obstacles and modifiable factors influencing the use of dermoscopy in daily dermatology practice across Europe. METHODS All registered dermatologists in 32 European countries were invited to complete an online survey of 20 questions regarding demographic and practice characteristics, dermoscopy training and self-confidence in dermoscopic skills, patterns of dermoscopy use, reasons for not using dermoscopy and attitudes relating to dermoscopy utility. RESULTS We collected 7480 valid answers, of which 89% reported use of dermoscopy. The main reasons for not using dermoscopy were lack of equipment (58% of nonusers) and lack of training (42%). Dermoscopy training during residency was reported by 41% of dermoscopy users and by 12% of nonusers (P < 0·001). Dermatologists working in public hospitals were the least likely to use dermoscopy. High use of dermoscopy across the spectrum of skin diseases was reported by 62% of dermoscopy users and was associated with dermoscopy training during residency, the use of polarized light and digital dermoscopy devices, longer dermoscopy practice, younger age and female gender. CONCLUSIONS Expanding access to dermoscopy equipment, especially in public healthcare facilities and establishing dermoscopy training during dermatology residency would further enhance the substantially high dermoscopy use across European countries.
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Affiliation(s)
- A M Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - V Del Marmol
- Dermatology Department, Universite Libre de Bruxelles, Hopital Erasme, Brussels, Belgium
| | - I Zalaudek
- Department of Dermatology and Venereology, Non-Melanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria
| | - H P Soyer
- Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Australia
| | | | - A C Geller
- Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A
| | - G Argenziano
- Dermatology Unit, Second University of Naples, Naples, Italy
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Design, synthesis and biological evaluation of novel benzo-α-pyrone containing piperazine derivatives as potential BRAF V600E inhibitors. Bioorg Med Chem Lett 2016; 26:4983-4991. [PMID: 27634195 DOI: 10.1016/j.bmcl.2016.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/13/2016] [Accepted: 09/02/2016] [Indexed: 12/25/2022]
Abstract
The increasingly acquired resistance to vemurafenib and side effects of known inhibitors motivate the search for new and more effective anti-melanoma drugs. In this Letter, virtual screening and scaffold growth were combined together to achieve new molecules as BRAFV600E inhibitors. Along with docking simulation, a primary screen in vitro was performed to filter the modifications for the lead compound, which was then substituted, synthesized and evaluated for their inhibitory activity against BRAFV600E and several melanoma cell lines. Out of the obtained compounds, derivative 3l was identified as a potent BRAFV600E inhibitor and exerted an anticancer effect through BRAFV600E inhibition. The following biological evaluation assays confirmed that 3l could induce cell apoptosis and marked DNA fragmentation. Furthermore, 3l could arrest the cell cycle at the G0/G1 phase in melanoma cells. The docking simulation displayed that 3l could tightly bind with the crystal structure of BRAFV600E at the active site. Overall, the biological profile of 3l suggests that this compound may be developed as a potential anticancer agent.
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Manne SL, Coups EJ, Kashy DA. Relationship factors and couples' engagement in sun protection. HEALTH EDUCATION RESEARCH 2016; 31:542-554. [PMID: 27247330 DOI: 10.1093/her/cyw027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 05/02/2016] [Indexed: 06/05/2023]
Abstract
Individuals may be more motivated to adopt health practices if they consider the benefits of these behaviors for their close relationships. The goal of this study was to examine couple concordance with sun protection and use the interdependence and communal coping theory to evaluate the role of relationship factors in sun protection. One hundred and eighty-four married couples aged 50 years and older completed measures of objective skin cancer risk, perceived risk, sun protection benefits, relationship-centered motivations for sun protection, discussions about sun protection, and sun protection. A mediational model was evaluated. Results indicated a high level of couple concordance. Partners who adopted a relationship-centered motivation for sun protection were more likely to discuss sun protection with one another, and partners who discussed sun protection together were more likely to engage in sun protection. One partner's attitude about personal risk and sun protection benefits was associated with the other partner's sun protection. Wives had higher relationship-centered motivation and discussed sun protection more with their husbands. Behavioral interventions may benefit from encouraging couples to discuss sun protection and encouraging married individuals to consider the benefits of sun protection for their relationship and for their spouse's health.
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Affiliation(s)
- S L Manne
- Section of Population Science, Department of Medicine, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, 08903, USA
| | - E J Coups
- Section of Population Science, Department of Medicine, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, 08903, USA
| | - D A Kashy
- Department of Psychology, Michigan State University, East Lansing, Michigan, 48824, USA
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Simberg-Danell C, Lyth J, Månsson-Brahme E, Frohm-Nilsson M, Carstensen J, Hansson J, Eriksson H. Prognostic factors and disease-specific survival among immigrants diagnosed with cutaneous malignant melanoma in Sweden. Int J Cancer 2016; 139:543-53. [PMID: 27004457 DOI: 10.1002/ijc.30103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 01/30/2016] [Accepted: 02/19/2016] [Indexed: 02/03/2023]
Abstract
Little is known about cutaneous malignant melanoma (CMM) among immigrants in Europe. We aimed to investigate clinical characteristics and disease-specific survival among first- and second-generation immigrants in Sweden. This nationwide population-based study included 27,235 patients from the Swedish Melanoma Register diagnosed with primary invasive CMM, 1990-2007. Data were linked to nationwide, population-based registers followed up through 2013. Logistic regression and Cox regression models were used to determine the association between immigrant status, stage and CMM prognosis, respectively. After adjustments for confounders, first generation immigrants from Southern Europe were associated with significantly more advanced stages of disease compared to Swedish-born patients [Stage II vs. I: Odds ratio (OR) = 2.37, 95% CI = 1.61-3.50. Stage III-IV vs I: OR = 2.40, 95% CI = 1.08-5.37]. The ORs of stage II-IV versus stage I disease were increased among men (OR = 1.9; 95% CI = 1.1-3.3; p = 0.020), and women (OR = 4.8; 95% CI = 2.6-9.1; p < 0.001) in a subgroup of immigrants from former Yugoslavia compared to Swedish-born patients. The CMM-specific survival was significantly decreased among women from former Yugoslavia versus Swedish-born women [hazard ratio (HR)=2.2; 95% CI = 1.1-4.2; p = 0.043]. After additional adjustments including stage, the survival difference was no longer significant. No survival difference between the second generation immigrant group and Swedish-born patients were observed. In conclusion, a worse CMM-specific survival in women from former Yugoslavia was associated with more advanced stages of CMM at diagnosis. Secondary prevention efforts focusing on specific groups may be needed to further improve the CMM prognosis.
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Affiliation(s)
- Caroline Simberg-Danell
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, SE, 171 76, Sweden
- Department of Dermatology and Venereology, Södersjukhuset, Stockholm, SE, 118 83, Sweden
| | - Johan Lyth
- Unit of Research and Development in Local Health Care, County of Östergötland, Linköping, Sweden
| | - Eva Månsson-Brahme
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, SE, 171 76, Sweden
- Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, SE, 171 76, Sweden
| | - Margareta Frohm-Nilsson
- Department of Medicine, Unit of Dermatology, Karolinska University Hospital, Stockholm, SE, 171 76, Sweden
| | - John Carstensen
- Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Johan Hansson
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, SE, 171 76, Sweden
- Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, SE, 171 76, Sweden
| | - Hanna Eriksson
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, SE, 171 76, Sweden
- Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, SE, 171 76, Sweden
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