演題抄録

International Session

開催概要
開催回
第54回・2016年・横浜
 

診療ガイドライン(日本)

演題番号 : IS17-1

[筆頭演者]
宇原 久:1 

1:信州大学・医学部・皮膚科

 

The number of skin cancer patients in Japan is rapidly increasing due to the aging of the population. The recent number of skin cancer patients nationwide is 20,000, with 1,600 deaths from skin cancer; the corresponding numbers for melanoma are 1,500-2,000 and 600. The first evidenced-based guideline for skin cancer in Japan was published in 2007, covering melanoma, squamous cell carcinoma, basal cell carcinoma and extramammary Paget's disease. Lymphoma was added in 2010. Although the guideline was revised in 2015, the contents cannot fully reflect the recent dramatic advance in melanoma treatment.

In Japan, the advance of systemic therapy for melanoma began in 2014. The first approval was for nivolumab in July 2014 (the world's first as an anti-PD-1 antibody), followed by vemurafenib in December 2014, ipilimumab in June 2015 and dabrafenib/trametinib in March 2016. The application for pembrolizumab is undergoing review. The following clinical trials are ongoing: the combination of ipilimumab and nivolumab, nibolumab (2 mg/every 3 weeks) vs. (3 mg/every 2 weeks), LGX818 +/- MEK 162 for advanced melanoma and, in an adjuvant setting, ipilimumab vs. nivolumab, pembrolizumab vs. observation, and interferon beta vs. observation, among others.

There is scant evidence regarding whether ethnic differences affect the efficacy and toxicity of immune checkpoint inhibitors and molecular targeted drugs. In Japan, there is a unique system of post-approval surveillance performed after a product's launch to collect adverse drug reaction data. The situation and issues regarding melanoma treatment in Japan will also be discussed.

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