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Analysis of Lymph Node Volume by Ultra-High-Frequency Ultrasound Imaging in the Braf/Pten Genetically Engineered Mouse Model of Melanoma
Published on: September 8, 2021
Clinical Implications of Acquired BRAF Inhibitors Resistance in Melanoma
Paola Savoia1, Elisa Zavattaro2, Ottavio Cremona3
1Department of Health Science, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy.
Abstract:
Understanding the role of mitogen-activated protein kinase (MAPK) pathway-activating mutations in the development and progression of melanoma and their possible use as therapeutic targets has substantially changed the management of this neoplasm, which, until a few years ago, was burdened by severe mortality. However, the presence of numerous intrinsic and extrinsic mechanisms of resistance to BRAF inhibitors compromises the treatment responses' effectiveness and durability. The strategy of overcoming these resistances by combination therapy has proved successful, with the additional benefit of reducing side effects derived from paradoxical activation of the MAPK pathway. Furthermore, the use of other highly specific inhibitors, intermittent dosing schedules and the association of combination therapy with immune checkpoint inhibitors are promising new therapeutic strategies. However, numerous issues related to dose, tolerability and administration sequence still need to be clarified, as is to be expected from currently ongoing trials. In this review, we describe the clinical results of using BRAF inhibitors in advanced melanoma, with a keen interest in strategies aimed at overcoming resistance.
Insights
Mitogen-activated protein kinase (MAPK) pathway mutations drive melanoma. Combination therapies targeting BRAF inhibitors show promise in overcoming resistance and improving treatment outcomes for advanced melanoma.
Area of Science:
- Oncology
- Molecular Biology
- Dermatology
Background:
- Melanoma treatment has been revolutionized by targeting mitogen-activated protein kinase (MAPK) pathway mutations.
- BRAF inhibitors have significantly improved outcomes but face challenges due to resistance mechanisms.
Purpose of the Study:
- To review the clinical efficacy of BRAF inhibitors in advanced melanoma.
- To explore strategies for overcoming resistance to BRAF inhibitors.
Main Methods:
- Review of clinical trial data and scientific literature on BRAF inhibitor therapy in melanoma.
- Analysis of intrinsic and extrinsic resistance mechanisms.
- Evaluation of combination therapy approaches.
Main Results:
- Combination therapies demonstrate success in overcoming BRAF inhibitor resistance.
- Reduced side effects observed with combination therapy due to less paradoxical MAPK pathway activation.
- Emerging strategies include targeted inhibitors, intermittent dosing, and combination with immune checkpoint inhibitors.
Conclusions:
- BRAF inhibitors are crucial in advanced melanoma management.
- Combination therapies and novel strategies are essential to enhance treatment durability and efficacy.
- Further research is needed to optimize dosing, tolerability, and administration sequences.
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