Multidisciplinary Care for Malignant Melanoma

For High-Definition, Click

The treatment of patients with metastatic melanoma requires a team approach. The complexities of this disease warrants impute from several specialists to properly deliver care, the panelists agree. Along these lines, however, one specialty that is commonly forgotten are the interventional radiologists, suggests Robert H.I. Andtbacka, MD. Interventional radiologists are getting more involved in the treatment of melanoma through the use of radiofrequency ablation on solitary metastatic lesions, Andtbacka notes.

A team approach is also important when managing side effects, particularly the colitis that can be associated with treatments like ipilimumab, as an example. As a surgeon, Andtbacka is aware of management strategies for this adverse event, such as steroid administration, from participating in multidisciplinary tumor boards. Treating the disease can be more art than science, adds Anna Pavlick, DO. This also extends to recognizing and managing dermatologic, gastrointestinal, and endocrine toxicities.

It is important to emphasize to patients that the management of a side effect may not impact the efficacy of treatment, Omid Hamid, MD, notes. Additionally, having a toxicity does not indicate that a treatment is working. This should be conveyed to patients.

A team approach and proper education is particularly important with the newer immune checkpoint inhibitors, adds Howard L. Kaufman, MD. With these agents, hormone levels should be assessed, requiring a certain level of expertise in endocrinology. In some situations, hypopituitarism can mimic disease progress and warrants assessment at every visit, Hamid suggests.

Related Videos
Nikhil Khushalani, MD, vice chair, Department of Cutaneous Oncology, Moffitt Cancer Center
Axel Hauschild, MD, PhD, head, Skin Cancer Trial Center, University Hospital Schleswig-Holstein
Ahmad Tarhini, MD, PhD
Nivolumab plus relatlimab vs nivolumab in previously untreated metastatic or unresectable melanoma (RELATIVITY-047): overall survival and melanoma-specific survival outcomes at 3 years
Long-term follow up for adjuvant dabrafenib plus trametinib in stage III BRAF-mutated melanoma: Final results of the COMBI-AD study
 Phase 3 study (PIVOTAL) of neoadjuvant intralesional daromun vs. immediate surgery in fully resectable melanoma with regional skin and/or nodal metastases
Zeynep Eroglu, MD
Zeynep Eroglu, MD
Zeynep Eroglu, MD
Zeynep Eroglu, MD