New advances
At the recent IFHNOS (International Federation of Head and Neck Oncological Societies) 2023 congress. in Rome, from the Australian Melanoma Institute in Sindey, a significant statement was published regarding additional therapeutic options in the treatment of melanoma.
Significant progress in knowledge and clinical application has been achieved in systemic therapy.

In many countries, new systemic therapy is already being integrated into existing treatment protocols, primarily with melanoma surgery, which is becoming more selective and less aggressive.

In the case of operative therapy, it is mandatory to include systemic therapy as surgery alone does not improve treatment outcome and prognosis.

What is the meaning of new modalities of systemic therapy (neoadjuvant therapy)?
- Potential improvement in survival compared to classical adjuvant therapy
- Potentially weak effect in earlier stages of the disease
- Safety for the patient in terms of reducing the aggressiveness of the treatment has yet to be proven
Gene testing - profiling in melanoma
- Newly introduced is the 31 Gene Expression Test (GEP), which was developed to try to predict a patient’s risk for disease recurrence (return) or metastatic disease, including the chance of sentinel lymph node positivity in a patient with stage I, II or III melanoma.
- This test detects the expression level of 31 genes that are associated with the occurrence of disease recurrence and metastatic pain, with the help of a quantitative RT-PCT test
- The test classifies patients as low-risk, moderate-risk, and high-risk
- It is intended as a guideline whether to perform a sentinel lymph node biopsy in patients older than 55 years with a tumor thickness of less than 2 mm.
- The current price of the test is an obstacle to its wide application in practice (> 7000 EUR)
- Davor Dzepina