Jornal de Ciência e Pesquisa do Câncer
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Cutaneous malignant melanoma: A review of confirmatory diagnosis and management

Piyu Parth Naik

The rising incidence of primary cutaneous melanoma and higher mortality rates associated with melanoma makes this issue a significant concern globally. A cure is possible with early detection of the disease. Biopsy techniques used for diagnosing a clinically suggestive lesion of melanoma are described, as per recommendations of the American Joint committee on Cancer (AJCC) system. CMs are extracted, keeping safe margins of 1-2 cm. Advancement in the laboratory, molecular, and imaging techniques is inspected in the melanoma cases which are newly diagnosed. For treatment strategies of primary cutaneous melanoma, recommendations for surgical margins and the excision techniques are discussed. The importance of sentinel lymph node biopsy as a staging technique for cutaneous melanoma is discussed in detail, with recommendations for its clinical practice efficiency. For cases of distant metastasis, all alternatives to surgical therapy should be considered together. However, systemic treatment is indicated in the absence of surgical therapies. First-line treatment in wild type B-RAF proto-oncogene (BRAF) patients, immunotherapy with programmed death-1 (PD-1) antibodies alone or combination therapy of PD-1 and cytotoxic T-lymphocyte antigen-4 (CTLA-4) antibodies should be preferred. Inhibitors of BRAF, such as dabrafenib and vemurafenib, combined with the mitogen-activated protein kinase (MEK) inhibitors trametinib and cobimetinib for BRAF mutated patients, should be considered for treatment. Finally, data regarding melanoma, testing, and management related to novel targeted agents and immunotherapies for advanced disease cases are summarized.