Evolution in Sinonasal Mucosal Melanoma Management

Abstract

Sinonasal mucosal melanoma is a rare and aggressive cancer with poor prognosis. Surgical resection with clear margins, when possible, remains the treatment of choice. Radiation therapy is generally used in the adjuvant setting with improved rates of local control following complete resection. Traditional chemotherapeutic agents do not improve the rates of locoregional control or survival. Immunotherapy has been used with some responders but with overall relatively poor outcomes. These outcomes highlight the need for new agents and more prospective trials in this space. We provide a unique case report of a patient with an advanced sinonasal mucosal melanoma and an overview of the recent literature pertaining to the management of this disease.

Keywords

melanoma - sinonasal mucosal melanoma - immunotherapy - management - review

Publication History

Received: 10 September 2021

Accepted: 08 November 2021

Article published online:
10 January 2022

• References

• 1 Chang AE, Karnell LH, Menck HR. The American College of Surgeons Commission on Cancer and the American Cancer Society. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. Cancer 1998; 83 (08) 1664-1678
• 2 Bachar G, Loh KS, O'Sullivan B. et al. Mucosal melanomas of the head and neck: experience of the Princess Margaret Hospital. Head Neck 2008; 30 (10) 1325-1331
• 3 Amit M, Tam S, Abdelmeguid AS. et al. Patterns of treatment failure in patients with sinonasal mucosal melanoma. Ann Surg Oncol 2018; 25 (06) 1723-1729
• 4 Flukes S, Lohia S, Barker CA. et al. Are our patients doing better? A single institution experience of an evolving management paradigm for sinonasal mucosal melanoma. Oral Oncol 2021; 112: 105006
• 5 Ascierto PA, Accorona R, Botti G. et al. Mucosal melanoma of the head and neck. Crit Rev Oncol Hematol 2017; 112: 136-152
• 6 Lazarev S, Gupta V, Hu K, Harrison LB, Bakst R. Mucosal melanoma of the head and neck: a systematic review of the literature. Int J Radiat Oncol Biol Phys 2014; 90 (05) 1108-1118
• 7 Ganly I, Patel SG, Singh B. et al. Craniofacial resection for malignant melanoma of the skull base: report of an international collaborative study. Arch Otolaryngol Head Neck Surg 2006; 132 (01) 73-78
• 8 Sayed Z, Migliacci JC, Cracchiolo JR. et al. Association of surgical approach and margin status with oncologic outcomes following gross total resection for sinonasal melanoma. JAMA Otolaryngol Head Neck Surg 2017; 143 (12) 1220-1227
• 9 Lund VJ. Sinonasal Malignant Melanoma. Adv Otorhinolaryngol 2020; 84: 185-196
• 10 Samstein RM, Carvajal RD, Postow MA. et al. Localized sinonasal mucosal melanoma: outcomes and associations with stage, radiotherapy, and positron emission tomography response. Head Neck 2016; 38 (09) 1310-1317
• 11 Krengli M, Jereczek-Fossa BA, Kaanders JHAM, Masini L, Beldì D, Orecchia R. What is the role of radiotherapy in the treatment of mucosal melanoma of the head and neck?. Crit Rev Oncol Hematol 2008; 65 (02) 121-128
• 12 Mikkelsen LH, Larsen AC, von Buchwald C, Drzewiecki KT, Prause JU, Heegaard S. Mucosal malignant melanoma - a clinical, oncological, pathological and genetic survey. APMIS 2016; 124 (06) 475-486
• 13 Öztürk Sari Ş, Yilmaz İ, Taşkin OÇ. et al. BRAF, NRAS, KIT, TERT, GNAQ/GNA11 mutation profile analysis of head and neck mucosal melanomas: a study of 42 cases. Pathology 2017; 49 (01) 55-61
• 14 Carvajal RD, Antonescu CR, Wolchok JD. et al. KIT as a therapeutic target in metastatic melanoma. JAMA 2011; 305 (22) 2327-2334
• 15 Guo J, Si L, Kong Y. et al. Phase II, open-label, single-arm trial of imatinib mesylate in patients with metastatic melanoma harboring c-Kit mutation or amplification. J Clin Oncol 2011; 29 (21) 2904-2909
• 16 Ascierto PA, Schadendorf D, Berking C. et al. MEK162 for patients with advanced melanoma harbouring NRAS or Val600 BRAF mutations: a non-randomised, open-label phase 2 study. Lancet Oncol 2013; 14 (03) 249-256
• 17 Dummer R, Schadendorf D, Ascierto PA. et al. Binimetinib versus dacarbazine in patients with advanced NRAS-mutant melanoma (NEMO): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2017; 18 (04) 435-445
• 18 Postow MA, Luke JJ, Bluth MJ. et al. Ipilimumab for patients with advanced mucosal melanoma. Oncologist 2013; 18 (06) 726-732
• 19 Shoushtari AN, Munhoz RR, Kuk D. et al. The efficacy of anti-PD-1 agents in acral and mucosal melanoma. Cancer 2016; 122 (21) 3354-3362
• 20 D'Angelo SP, Larkin J, Sosman JA. et al. Efficacy and safety of nivolumab alone or in combination with ipilimumab in patients with mucosal melanoma: A pooled analysis. J Clin Oncol 2017; 35 (02) 226-235