Melanoma

Strategies of treatment involving therapeutic proteins, irnrnune immune cells, or cel lular protein targets are those of greatest potential for further reducing mortality from melanoma. Therapeutic proteins or cells may inhibit melanoma cell growth either by augmentation of immune cell function or by inhibition of angiogenesis. Cytokines and melanoma antigens may be used either in vivo as a vaccine to stimulate irnrnune immune cell cell function or ex vivo to stimulate or proliferate cells for infusion. Alternatively, alteration in melanoma cell growth can occur through inhibition of protein signal transduction pathways within melanoma cells or in the endothelial cells constituting the necessary angiogenic support for tumor growth. The great promise of these therapies and their cellular targets constitutes the basis for Melanoma: Biologically Targeted Therapeutics. THE CLINlCAL PROBLEM More than four million people will be diagnosed with melanoma in the first decade of the 21st century. Half of those who will die will be individuals who would otherwise have had a life expectancy of another 25 years or more. These individuals will die of systemic systernic metastases, which are present at the time of primary surgery. Despite use of sunscreens, incidence continues to increase in developed countries worldwide. To reduce mortality, there must continue to be a focus on prevention and earlier detection through public education. Early interventions are always preferable to treatment of disseminated metastatic disease.

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Klappentext
Substantial progress in the effective prevention and treatment of primary and recurrent melanomas is now being regularly achieved using therapeutic proteins and cells. In Melanoma: Biologically Targeted Therapeutics, Ernest C. Borden, MD, has assembled a multidisciplinary team of established and emerging leaders to detail the clinical problems and factors influencing the therapeutic deployment of these biologicals. Throughout, the focus is on providing the rationale and background by which the many promising biologically targeted therapies are translated via clinical trials into effective new therapies. Among the interventional agents treated are cytokines, monoclonal antibodies, targeted inhibitors, cellular therapies, and angiogenesis inhibitors. Special attention is given to adjuvant therapies for melanoma in patients staged as being at high risk for recurrence. These therapies include interferons, vaccines aimed at stimulating T cell response, and therapies targeted at abnormal melanoma cell proliferative signaling and angiogenesis inhibitors. Among the cutting-edge therapies discussed are novel cytokines that influence dendritic NK and T cell function, an allogenic cellular extract vaccine, and new targets (NF-kB and IL-8) for antiangiogenesis therapies.
State-of-the-art and forward looking, Melanoma: Biologically Targeted Therapeutics critically evaluates the biological, cellular, and targeted therapies that are already reducing mortality from primary melanomas, and are expected increasingly to continue so for the foreseeable future.

Inhalt
I Perspective on the Clinical Disease.- 1 Management of Primary Malignant Melanoma.- 2 A Pathologist's Perspective on Prognostic Featuresof Malignant Melanoma.- 3 Clinical Prognostic Factors and Staging.- II Biological and Targeted Therapeutics.- 4 Principles of Antitumor Immunity and Tumor-Mediated Immunosuppression.- 5 Immunotherapy of Advanced Melanoma Directed at Specific Antigens.- 6 Melanoma Antigens: Vaccines and Monoclonal Antibodies.- 7 Interleukin-2.- 8 Interleukin-12: Immunologic and Antitumor Effects in Human Malignant Melanoma.- 9 Interferons: Preclinical and Clinical Studies in Melanoma.- 10 Biochemotherapy of Melanoma.- 11 Signal Transduction Abnormalities as Therapeutic Targets.- 12 Tumor Angiogenesis.- 13 Antiangiogenic Therapy for Melanoma.