Photo Credit: Stefanamer

With all cancers, clinician expertise is vital when informing patients about their disease, diagnosis, and treatments and when recruiting patients into clinical trials.

There have been many advances in the treatment of melanoma following the introduction in 2011 of ipilimumab, which is approved for the treatment of unresectable melanoma and for treatments in the adjuvant setting. Although new treatments for melanoma have improved the overall survivor rate, cases of melanoma continue to rise; some countries report a 3% annual increase. With more cases and promising treatment options, health care practitioners seek clear, evidence-based guidance as they continue establishing their treatment protocols.

In 2022, the International Agency for Research on Cancer estimated that there were 324,635 new cases of melanoma and 57,043 deaths globally. In the United States, researchers anticipate 97,620 new diagnoses of melanoma and 7,990 deaths in 2023.

The American Society of Clinical Oncology (ASCO) convened a panel of experts in the study and treatment of melanoma to conduct a systemic review of the literature on treatment currently available. This updated review includes the scrutiny of 21 additional randomized trials, providing practitioners with clear insights into best practices.

A co-chair of the expert panel that developed the Systemic Therapy for Melanoma: ASCO Guideline Update, Rahul Seth, DO, spoke with PW about the findings of this updated practice guideline.

PW: What was the impetus behind this guideline? 

Dr. Seth: We aimed to provide updated guidance for clinical oncologists who treat patients with melanoma to help them navigate through new developments in systemic therapy for the disease. ASCO, a front-runner for guidelines targeting oncologists, convened an expert panel to conduct an updated systemic literature review.

PW: Which findings of this reassessment are the most important for physicians to understand?

 Dr. Seth: The guideline reveals a growing awareness of new data for adjuvant therapy, focused on B-raf proto-oncogene gene mutations and novel regimens for metastatic disease.

PW: How should these updated guidelines be incorporated into practice?

Dr. Seth: Any healthcare professional seeking help in treating their patients can access all guidelines. Each recommendation provides ratings for type, strength, and overall evidence (Table).

PW: What would you like future research to focus on? What still needs to be explored to expand these guidelines in the future?

Dr. Seth: Going forward, research will look at next-generation sequencing to help pinpoint treatment options for patients with metastatic skin cancer and the best options for adjuvant chemotherapy. This research will help determine aggressive melanoma versus nonaggressive melanoma.

PW: What else do you feel Physician’s Weekly readers would benefit from knowing about your research?

Dr. Seth: Our research is focused on providing patients with the most effective treatment options. Additionally, the researchers strived to provide QOL to patients with metastatic cancer and designed the study to uncover adjuvant treatment.

For patient care and the dissemination of information, Dr. Seth and colleagues published the updated guidelines in the Journal of Clinical Oncology. “With all cancers, clinician expertise about a patient’s disease, diagnosis, treatments, and clinical trials is crucial,” Dr. Seth says. “Information should allow patients to feel enabled. A patient who finds agency with the information they receive is more likely to be  more proactive, more motivated, more adherent, and better able to deal with their diagnosis.”