Dysplastic nevus medical therapy

Dysplastic nevus Microchapters
Home
Patient Information
Overview
Classification
Pathophysiology
Causes
Differentiating Dysplastic nevus from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Dysplastic nevus medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Dysplastic nevus medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Dysplastic nevus medical therapy
CDC on Dysplastic nevus medical therapy
Dysplastic nevus medical therapy in the news
Blogs on Dysplastic nevus medical therapy
Directions to Hospitals Treating Dysplastic nevus
Risk calculators and risk factors for Dysplastic nevus medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

The mainstay of therapy for dysplastic nevus is surgery, however radiation therapy or chemotherapy may be administered in metastatic disease.

Medical treatment

Dysplastic nevi are associated with increased risk of melanoma, management includes risk evaluation along with other procedures. The mainstay of therapy for dysplastic nevus is surgery, however radiation therapy or chemotherapy may be incorporated in metastatic disease. Surgical excision of dysplastic nevi is generally recommended with a positive histologic margin.

Dysplastic nevi can be categorized into risk categories:

• Mildly, mildly-to-moderately, and moderately dysplastic nevi generally appearing as low-risk lesions,
• Moderately-to-severely and severely dysplastic nevi appearing to carry a higher risk for coexistent or future melanoma.

Chemotherapy regimens

Chemotherapy, however, is indicated for the following patient subgroups:

• Patients with high risk melanomas (Stage IIB-IV) - Adjuvant therapy using interferon therapy
• Patients with metastatic disease - First-line therapy using either a single agent or combination regimen.
• Several single agent and combination regimens have been studied, all with modest impact on survival.

*All current guidelines still recommend enrollment in clinical trials over current available regimens for patients with metastatic disease. Below is a summary of available adjuvant and treatment regimens.

Adjuvant therapy

1. Interferon alfa-2a (Roferon-A)
2. Interferon alfa-2b (Intron-A)
3. Peginterferon alfa-2b (Sylatron)

Metastatic or unresectable melanoma

Either a single agent chemotherapy OR a combination chemotherapy is recommended for metastatic or unresectable melanoma.

• Single Agent Chemotherapy

1. Dabrafenib (Tafinlar)
2. Dacarbazine (DTIC)
3. Docetaxel (Taxotere)
4. Interleukin-2 (high dose or maintenance biotherapy)
5. Imatinib (Gleevec)
6. Ipilimumab (Yervoy)
7. Nivolumab (Opdivo)
8. Paclitaxel (Taxol)
9. Pembrolizumab (Keytruda)
10. Temozolomide (Temodar)
11. Trametinib (Mekinist)
12. Vemurafenib (Zelboraf)

• Combination Chemotherapy

1. Paclitaxel nanoparticle albumin-bound + Bevacizumab + Carboplatin (ABC)
2. Carboplatin + Paclitaxel
3. Carboplatin + Paclitaxel + nanoparticle albumin-bound
4. Carboplatin + Paclitaxel +, Sorafenib
5. Cisplatin + Dacarbazine ± Carmustine
6. Cisplatin + Dacarbazine + IL-2 + IFN alfa-2b ± Carmustine
7. Cisplatin + Paclitaxel + Dacarbazine
8. Cisplatin + Vinblastine + Dacarbazine
9. Cisplatin + Vinblastine + Dacarbazine + IL-2 + IFN alfa-2b (sequential biochemotherapy)
10. Temozolomide + Bevacizumab
11. Dabrafenib + Trametinib
12. Ipilimumab + Dacarbazine
13. Ipilimumab + Nivolumab