Académie royale de Médecine de Belgique

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Résumé Uwe Reinhold

(Séance du 28 avril 2001)

CUTANEOUS MALIGNANT MELANOMA : FROM EARLY DIAGNOSIS TO GENE THERAPY  p

par U. REINHOLD (University de Homburg/Saar – RFA), invité.

Cutaneous melanoma is a disease which represents a challange to the whole community of clinicians and researchers.  The increase in incidence throughout all Western countries; the improved knowledge of its biological and immunological characteristics, the improvements in the diagnostic accuracy of early lesions, and, on the other hand, the continuing disappointing results of treatment regimens in patients with metastatic disease are all elements which stimulate the world wide interest of clinicians and laboratory workes.  Knowledge about diagnostic procedures in melanoma has increased rapidly within the past few years.  These new techniques include the epiluminescence microscopy and computerized image analysis of pigmented skin lesions as well as the identification of single tumor cells in normal tissue such as sentinel lymph nodes and peripheral blood by molecular approaches.  The introduction of polymerase-chain reaction based methods can be regarded as a prototype of this dramatic development that opens up the possibility of clinical use in patients and of influencing treatment strategies.  While early melanoma is highly curable by surgical means, the prognosis of patients with metastatic disease remains poor.  A flurry of new treatment strategies are currently in clinical development.  These include systemic chemotherapy, biochemotherapy, biologic therapy, vaccine therapy, as well as gene therapy.  All different therapeutic strategies have to take into account immense resistance and escape mechanisms of malignant melanoma cells that potentially limit the effectiveness of new treatment concepts.  Thus one of the current goals in melanoma research is to analyses and modify immune escape and resistance mechanisms of melanoma cells that will lead to better therapeutic interventions.

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