The European body fighting cancer places melanoma sixth among the most common cancers in 2023. In France, according to the National Cancer Institute, the number of new cases is increasing by 2% despite prevention campaigns. br>
A very rapid evolution
Faced with the very rapid evolution of the place of immunotherapy in the treatment of melanoma, which has considerably improved the prognosis of this skin cancer, the National Academy of Medicine highlights the following elements.
Benefit/risk assessment
The development and promotion of actions to prevent skin melanoma among the wider public remains a public health action of great importance. The benefit/risk ratio must be assessed before any decision on immunotherapy, particularly at an early stage of the disease, due to the possibly permanent nature of autoimmune side effects.
The search for predictive markers of resistance
Two important issues for the years to come are: On the one hand, the search for predictive markers of risk of serious progression of melanoma, to identify the indications for adjuvant treatment, on the other hand, the search for predictive markers of response or resistance to immunotherapy and identification of the profile of patients most at risk of severe side effects.
Long-term follow-up of patients
Certain types of melanomas, such as ocular, mucosal, or extremity melanomas, are not very sensitive to current immunotherapy. It is essential to set up cohorts allowing long-term monitoring of patients undergoing adjuvant treatment, in particular to assess the benefit on overall survival. The considerable progress observed in recent years in the treatment of melanoma has also been made possible by the provision of very high-cost treatments.
 Didier Galibert
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16/10/2023 | 
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