“Mortality from melanoma has increased in recent years”

What is the current situation of melanoma in Spain?

The incidence of melanoma has been increasing in recent decades. Although early diagnosis facilitates the detection of a greater number of cases in early stages, mortality has also increased in recent years. It is estimated that the incidence of melanoma in Spain is 5 cases per 100,000 inhabitants. This pathology is detected more frequently in the young population; one third of cases are diagnosed in people under 50 years of age. In recent years, in order to prevent melanoma, public awareness and information campaigns have been carried out.

What is the difference between melanoma in its early stages and advanced melanoma?

Through dermatological examination in units specialized in pigmented skin lesions, it is possible to diagnose many lesions early, that is, when they are still in situ or low-risk tumors. Today, most melanomas are detected in the early stages, when they can still be cured. However, when melanoma spreads, it becomes a complicated disease to cure. Until a few years ago, treatments were very limited, basically reduced to chemotherapy, with poor results.

Advanced melanoma is one of the most aggressive tumors. However, it is one of the few tumors that can be eliminated when the immune system is properly stimulated. Moreover, it is one of the tumors in which the main key genetic alterations in tumor development are already known, which makes it possible to use specific treatments based on the molecular profile with better results and less toxicity.

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What are the new advances in the treatment of advanced melanoma?

Multiple genetic alterations have been recognized in melanoma. Basically, mutations in the BRAF, CKIT and NRAS genes are the ones that are currently susceptible to pharmacological inhibition. For the diagnosis of these genetic alterations in melanoma, in addition to the traditional biopsy, detection in blood is of special interest, as if it were a biopsy but, on this occasion, “liquid”. In this context we are carrying out clinical studies in the Molecular Oncology Laboratory of the Dr Rosell Oncology Institute (IOR).

Currently, both ipilimumab (monoclonal antibody against CTLA4) and vemurafenib and dabrafenib (BRAFV600 inhibitors) have been approved for the treatment of advanced melanoma. In Spain they are already available through the compassionate use option for some anti-PDL1 drugs that obtain high rates of activity with long responses and excellent tolerance.

When the disease is detected in advanced stages, one need prevails over the rest: to be able to access early diagnosis and the best applicable treatments.