Treatment of skin cancer
The Gustave Roussy Dermatology Committee is responsible for the management of patients with skin cancer, cutaneous tumours or cutaneous side effects resulting from anti-cancer therapy.
The main conditions seen are:
- melanomas: superficial spreading melanoma, nodular melanoma, acral lentiginous melanoma, lentigo maligna melanoma, choroidal or mucosal melanomas
- carcinomas: squamous cell carcinoma, basal cell carcinoma, cancers of skin appendages and neuroendocrine tumours
At Gustave Roussy, decisions about treatment are taken at multidisciplinary consultative committee meetings (RCP), which gather together a number of doctors from different specialties: radiologists, pathologists, surgeons, medical oncologists, etc. working closely with private practitioners from outside the Institute. These doctors consider the results of investigations and decide on the most appropriate treatment for each type of cancer and each individual. A consultant physician then explains the committee’s decision to the patient and the patient’s family.
The Dermatology Committee is deeply involved through its head, Prof. Caroline Robert, in research projects carried out by the lab "Adaptative resistance to anticancer therapies": identification of mechanisms of drug resistance in melanoma, exploration of markers of drug efficacy and drug resistance and development of novel therapeutic strategies.
Many therapeutic strategies have been opened up:
- therapies targeted against a genetic abnormality (anti-BRAF or anti-MEK)
- immunotherapies (anti-CTLA4, ipilimumab)
- anti-angiogenic drugs intended to reduce tumour blood supply
- new chemotherapeutic agents or drug combinations.
Several clinical trials are in progress on these novel drugs, which have been shown to be effective.
Melanoma risk factors
As the most aggressive skin cancer, melanoma has several risk factors:
- Exposure to the sun and ultraviolet rays
- Chronic cumulative exposure
- Patients with light-coloured skins (phototypes I and II) are at much greater risk
- There is a familial predisposition in about 10 % of patients with melanoma (at least 2 individuals in the same family). This particularly applies to the carriage of CDKN2A or p16 and CDK4 genes
- The dysplastic naevus syndrome (large numbers of naevi)
- Congenital naevi (present from birth) are at risk of transformation which is linked to their size
- Xeroderma pigmentosum (a genetic condition)