Eosinophilic granulocytes as a potential prognostic marker for cancer progression and therapeutic response in malignant melanoma.

The importance of eosinophilic granulocytes in cancer has been widely discussed in recent years. The current study reviews the evidence on the role of eosinophilic granulocytes in melanoma as a prognostic marker for cancer progression and the efficacy of treatment with modern immune checkpoint inhibitors. A total of 33 human clinical studies were included in the review, with heterogeneous data due to differences in patients populations, study design and inclusion of small study groups. However, 28 of the 33 studies suggested that eosinophilic granulocytes could be used as a prognostic biomarker for outcome and/or potential response to systemic treatment and/or occurrence of adverse events in melanoma patients. Nevertheless, the exact role of eosinophils remains to be elucidated. Further prospective, larger and better controlled studies are warranted to clarify the significance of eosinophilic granulocytes in patients with melanoma, in more details.

Melanoma Prognosis and Associated Risk Factors: A Retrospective Cohort Study Using Semantic Map Analysis.

The overall patterns of correlations among various melanoma risk factors have not yet been examined. The aim of this study was to assess the impact of different parameters on disease-free and melanoma-related overall survival. A retrospective cohort study was conducted encompassing all patients with a primary cutaneous melanoma diagnosed in a university referral centre. Associations were explored using semantic map analysis, which uses graph theory to find the strongest path of connections between variables. A total of 1,110 melanoma patients (median follow-up 10.6 years) were included. The analysis revealed a clustering of variables around 2 main hubs: Breslow thickness < 1 mm and ≥ 4 mm. Factors connected with high melanoma thickness were: older age, positive sentinel lymph node biopsy findings, presence of ulceration, nodular melanoma type, and light skin phototype. Both disease-free and melanoma-related overall survival were in this cluster and connected with positive sentinel lymph node biopsy and Breslow ≥ 4 mm. Patients with Breslow between 1 and 3.9 mm were also in this cluster and linked with negative sentinel lymph node biopsy, nodular melanoma and safety distance > 10 mm. This semantic analysis confirmed the close link between Breslow thickness, age, sentinel lymph node biopsy findings, skin type, melanoma subtype and prognosis, and provides prognostic information useful for the further stratification and management of patients with melanoma.

Recent Successes and Future Directions in Immunotherapy of Cutaneous Melanoma.

The global health burden associated with melanoma continues to increase while treatment options for metastatic melanoma are limited. Nevertheless, in the past decade, the field of cancer immunotherapy has witnessed remarkable advances for the treatment of a number of malignancies including metastatic melanoma. Although the earliest observations of an immunological antitumor response were made nearly a century ago, it was only in the past 30 years, that immunotherapy emerged as a viable therapeutic option, in particular for cutaneous melanoma. As such, melanoma remains the focus of various preclinical and clinical studies to understand the immunobiology of cancer and to test various tumor immunotherapies. Here, we review key recent developments in the field of immune-mediated therapy of melanoma. Our primary focus is on therapies that have received regulatory approval. Thus, a brief overview of the pathophysiology of melanoma is provided. The purported functions of various tumor-infiltrating immune cell subsets are described, in particular the recently described roles of intratumoral dendritic cells. The section on immunotherapies focuses on strategies that have proved to be the most clinically successful such as immune checkpoint blockade. Prospects for novel therapeutics and the potential for combinatorial approaches are delineated. Finally, we briefly discuss nanotechnology-based platforms which can in theory, activate multiple arms of immune system to fight cancer. The promising advances in the field of immunotherapy signal the dawn of a new era in cancer treatment and warrant further investigation to understand the opportunities and barriers for future progress.

Epithelial skin cancers after kidney transplantation: a retrospective single-centre study of 376 recipients.

Post-transplant non-melanoma skin cancers (NMSC) are the most common malignancies in kidney transplant recipients. To analyse risk factors associated with the occurrence of basal cell carcinomas (BBC) and squamous cell carcinomas (SCC) in kidney transplant recipients. Statistical analysis was performed on 376 kidney transplant recipients screened for NMSC in 2002-2009 and followed until 2013. NMSC developed in 23.67% of individuals with an SCC/BCC ratio of 2.15:1 and an age-standardised incidence ratio (IR) of 2.71 cases (95% CI: 1.97-3.46) per 100 patients/year. Based on multivariable analysis, NMSC occurrence significantly correlated with higher age (p<0.001), fair skin type (p = 0.01), and particularly SCCs with male gender (p = 0.001). Patients with >10 actinic keratoses were at higher risk of developing NMSCs (IRR = 2.95; 95% CI: 1.97-4.42; p<0.001) and more prone to SCCs, compared to BCCs (p = 0.04). Also, more SCC carriers had high counts of warty lesions (p = 0.006). Calcineurin inhibitors were associated with higher NMSC incidence (IRR = 2.81; 95% CI: 1.1-7.01; p = 0.03), while no difference was seen with the mammalian target of rapamycin (mTOR) inhibitors. Our results confirm an influence of the individual immunosuppressive regimen, in addition to the duration of immunosuppression, and suggest that older patients, males, fair skinned recipients or those affected with high counts of actinic keratoses (field cancerisation) are particularly prone to development of NMSC.

Ultraviolet radiation protection and skin cancer awareness in recreational athletes: a survey among participants in a running event.

PRINCIPLE: Ultraviolet radiation (UVR) protection and skin cancer awareness are essential in the avoidance of cutaneous malignancies. Skin cancer prevention programmes involve public educational campaigns, for example, for outdoor workers or school children. Since nonprofessional sun exposure (e.g. during outdoor sport) is increasing with today's lifestyle, we assessed UVR protection and skin cancer awareness among recreational athletes. This survey-based, paper/pencil study was designed to assess UVR protection and skin cancer awareness among recreational athletes attending the largest running event in Switzerland. METHODS: All adults (age 18 and older) attending this run were invited to complete our survey at our study booth. Our form consisted of questions about participants' personal characteristics such as age, gender, educational attainment, skin type, history of sunburns, and personal/family history of skin cancer, as well as participants' subjective attitudes and behaviours relating to UVR protection and skin cancer avoidance. We calculated separate scores for individual UVR protection and skin cancer awareness. We tested these two scores in relation to educational level as a primary endpoint. In addition, the impacts of further distinct characteristics were assessed in multivariable analysis. RESULTS: A total of 970 runners (457 males, 513 females, mean age 41.0 years) completed our survey. Our results indicate that UVR protection is dependent on age, gender, skin type and personal history of skin cancer. Educational attainment (at univariate level), age, gender and skin type (in multivariable analysis) significantly affected the skin cancer awareness score. CONCLUSION: Our findings suggest that protection measures among recreational sportsmen can be improved. Achievements are notable in older, fair skinned, female runners. Our findings indicate that further work is needed in the education of the general public, and athletes in particular.