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Onkologie 25. März 2016

Treatment of elderly patients with melanoma

Treatment options for melanoma patients, both young and old, were extremely limited until recently. Elderly patients faced a particular challenge due to less aggressive surgical management, poor tolerance of available therapies, aggressive biologic behaviors, and rapid tumor progression. Over the past several years, however, a number of remarkably active immune and targeted agents have been developed. These agents are generally well tolerated and present numerous effective therapeutic options for elderly patients with advanced melanoma. In this manuscript, we discuss the distinct clinical and genetic aspects of melanoma in elderly patients. Furthermore, we review treatment options for older patients with local and regional melanoma and disseminated disease.

Introduction

Treatment for advanced melanoma has recently undergone a remarkable transformation. Historically, therapeutic options were limited and were associated with substantial morbidity and marginal efficacy. Since 2011, diverse arrays of immune and targeted therapies have been developed that provide superior benefits and are associated with generally milder toxicities. As such, therapy options for elderly patients with advanced melanoma have multiplied. In this review, we will discuss treatment options for patients with melanoma with an emphasis on elderly patients (more than 75 years old). We will primarily focus on advanced disease but will briefly discuss surgical and adjuvant treatment strategies.

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