University of Groningen
Developments in the treatment of advanced melanoma
Sloot, Sarah
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Publication date: 2017
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Sloot, S. (2017). Developments in the treatment of advanced melanoma. University of Groningen.
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Outline of the
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Outline of the dissertationOutline of the dissertation
The introduction in the previous chapter has provided insights in melanoma diagnostics, biology, prognosis and treatment and has shown that although treatment options have significantly expanded over the past decades, once disseminated, melanoma is still a fatal disease with a somber prognosis for the majority of patients.
This dissertation generates insights on all steps of the treatment of advanced melanoma. It starts out with answering the important question whether sentinel lymph node biopsy leads to more intralymphatic metastases, then gives an update on locoregional treatment of melanoma, both infusion/perfusion techniques and intralesional treatment, and generates data for a potential neoadjuvant strategy with BRAF inhibitors. Lastly, this dissertation will investigate the effect of the recent additions to systemic treatments in melanoma brain metastasis and the resulting changes in prognosis. These insights aim to assist in clinical decision making.
Part I - Locoregional treatment developments in advanced melanoma
The relationship between sentinel lymph node biopsy and intralymphatic metastases is investigated and regional and intralesional therapies are reviewed.
Chapter 3
Is there a relation between type of primary melanoma treatment and the development of intralymphatic metastasis? A review of the literature
Chapter 4
Regional therapy in metastatic melanoma: an update on minimally invasive intra-arterial isolated limb infusion and percutaneous hepatic perfusion Chapter 5
Intralesional therapy for metastatic melanoma Part II - BRAF treatment in advanced melanoma
The potential use of BRAF-targeted therapy as a neoadjuvant strategy is described and long term effects of BRAF-targeted therapy are reviewed, which is increasingly relevant as more long term survivors who continue on BRAF therapy are identified.
Chapter 6
BRAF inhibition for advanced locoregional BRAF V600E mutant melanoma: a potential neoadjuvant strategy
Chapter 7
Long-term effects of BRAF inhibitors in melanoma treatment: friend or foe? Part III - Developments in melanoma brain metastasis
One of the largest cohorts of melanoma brain metastasis patients in current literature is identified and prognostic factors, impact of new treatments and survival are investigated. Chapter 8
Improved survival of patients with melanoma brain metastases in the era of targeted BRAF and immune checkpoint therapies
This dissertation will finish up with a discussion of the reported research results and expected future developments. A summary is provided in English and Dutch. The appendices include the curriculum vitae of the author, acknowledgements and the author’s list of publications.
