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PT3 Oncology > melanoma > Flashcards

Flashcards in melanoma Deck (18):
1

phenotypic risk factors of melanoma

-fair complexion
-red or blonde hair
-presence of >50 moles
-presence of atypical moles
-family history
-male
->60

2

environmental risk factors of melanoma

-Hx of excess sun exposure
-tanning bed use
-history of severe sunburns as child or teen
-exposure to UV treatment

3

growth sequence of melanoma

-radial growth phase (lateral)
-vertical growth phase
-lymph system distribution
-vascular distribution

4

things to evaluate in determining the stage of melanoma

-depth of invasion
-ulceration of tumor
-mitotic rate
-lymphovascular invasion

5

follow up staging to be done after initial staging

-sentinel lymph node biopsy (Breslow depth)
o if it is + then CT of chest or PET CT
-genetic testing for BRAF and cKIT mutations

6

most common mutation in melanoma

BRAF v600E

7

treatment decisions of melanoma are based on

-age
-comorbid disease states
-stage
-genetic mutations
-patient wishes/desires

8

typical treatment for stage 0 and 1 melanoma

wide excision surgery
surveillance

9

typical treatment for stage 2 melanoma

wide excision surgery
sentinel lymph node biopsy
surveillance

10

typical treatment for stage 3 melanoma

surgery
adjuvant immunotherapy

11

typical treatment for in transit mets

surgery
intra-lesional immunotherapy?
adjuvant immunotherapy

12

typical treatment for stage 4 melanoma

palliative immunotherapy and surgery/radiation

13

immunotherapy of choice in melanoma

nivolumab
14 day cycle, 1 year therapy

14

drug therapy if BRAF v600 mutation is present

dabrafenib/trametinib

15

drug therapy if cKIT mutation is present

imatinib

16

drug therapy for metastatic melanoma

ipilimumab/nivolumab

17

what is talimogene laherparepvec (Tvec)

-genetically modified herpes simplex that infects and destroys melanoma cells
-currently adjuvant therapy

18

things to monitor for in immunotherapy

-TSH level
-hypophysitis
-rash
-diarrhea
-cough lasting more than 2 days