Ganglioside GM3:GD3 ratio as an index for the management of melanoma

Article Abstract:

Malignant melanoma is the most dangerous form of skin cancer. Furthermore, it seems to be well on its way to becoming one of the most common forms of cancer as well. In 1982, it was predicted that the rate of melanoma among Americans might be 1 case in every 150 persons by the year 2000. By 1990, however, the frequency of melanoma was increasing at such a pace that the turn-of-the century rate of this cancer is more likely to be about 1 case in every 90 individuals. Fortunately, the rate of cure of this disease is rising as well. This is primary due, however, to greater public awareness and an increase in early diagnosis. The rate of cure for all but the earliest stages of melanoma remains poor. From 90 to 95 percent of patients with melanoma localized in the skin lesion may be cured. The cure rate drops to 25 to 35 percent if the cancer has begun to spread to the lymph nodes, that is, Stage II melanoma. Researchers have found that the malignant cells of a melanoma have different lipids in their membranes than do normal pigmented skin cells. Lipids are nothing more than fats, but cell membranes contain highly specialized fats with complex molecular structures. One such specialized group of lipids is the gangliosides. One common ganglioside is abbreviated GM3; in melanoma cells this ganglioside is preferentially converted into another form called GD3. Since the relative amount of GD3 may prove to be a useful prognostic indicator, the ratio of GM3 to GD3 was measured in the melanomas of 42 patients with Stage II disease. The patients were then grouped into three categories based on this ratio. The 10 patients in group one whose GM3:GD3 ratio ranged between 15 to 1 and 1.5 to 1 had the best overall survival. All of the patients in the other two groups died; 13 patients in group two with a ratio of GM3:GD3 between 1.4 to 1 and 1.0 to 1.4, and 19 patients in group three with a ratio between 1 to 1.5 and 1 to 5. These results suggest that patients with a greater relative amount of GD3 are not likely to survive with treatments that are currently available and should be treated more aggressively. It may become possible to treat these patients with specific antibodies designed to recognize the GD3 molecule itself. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Prognosis, Gangliosides

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A phase I-II study of dacarbazine in combination with outpatient interleukin-2 in metastatic malignant melanoma

Article Abstract:

Malignant melanoma is a pigmented form of skin cancer which shows a high propensity for metastatic spread; the prognosis for malignant melanoma is poor. For this reason, the observation of responses to treatment with interleukin-2 (IL-2) by patients with this cancer have been viewed as encouraging. IL-2, which was originally called T-cell growth factor, has a variety of effects on some cells. To determine if IL-2 might be advantageously combined with another chemotherapeutic agent, 32 patients with metastatic melanoma were treated with IL-2 and dacarbazine. Dacarbazine was chosen because it has a 10 to 19 percent response rate in melanoma, and does not seem to have any schedule-dependent clinical effects. The melanoma patients all had disease which was not surgically treatable, and their life expectancy was estimated to be four months. Of the 32 patients treated with dacarbazine and IL-2, one complete response and six partial responses were observed. While the average duration of response was 4.7 months, one patient has remained in partial remission for two years. Another patient was able to undergo surgery after a partial response and is disease-free at 18 months. The patients who did not respond to the treatment lived an average of 6.9 months, while the average survival of the responding patients was 22 months. The results show that the combination of IL-2 with other chemotherapeutic agents may prove useful in treating metastatic melanoma. In the present study, metastatic tumors in the lymph nodes, liver, skin, and lungs responded, but no response was observed in the brain, pancreas, or spleen. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Chemotherapy, Interleukin-2, Dacarbazine

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