A Brief Review on Malignant Melanomas

Mohamed Abdelbari Mattar*

Department of Neurosurgery, Mansoura University, Egypt

Received: 01-Jun-2022, Manuscript No. ACTVR-22-70500; Editor assigned: 03-Jun-2022, PreQC No. ACTVR-22-70500 (PQ); Reviewed: 17- Jun-2022, QC No. ACTVR-22-70500; Revised: 22-Jun-2022, Manuscript No. ACTVR-22-70500(R); Published: 29-Jun-2022, DOI: 10.37532/ actvr.2022.12(3).63-65

Abstract

One of the most prevalent cancers, melanoma has a significant fatality risk if it is not caught early. Recent research on deep learning techniques demonstrates promising outcomes in the creation of computer-aided diagnosis for precise disease identification. The body of research supporting novel melanoma therapies is growing quickly. This may not always be reflected in the advice provided right now. The widely used 2015 National Institute for Health and Care Excellence (NICE) guideline for melanoma has recently been updated, according to a UK-based expert consensus statement published in JPRAS (NG14). We sought to evaluate NG14’s quality in comparison to all subsequent melanoma recommendations. Over the past ten years, there have been notable advancements in the treatment of melanoma In addition to reviewing the most recent clinical studies that will be useful in the near future; we explain historical patterns in the treatment of this condition in this article. Advanced melanoma was traditionally treated with chemotherapeutic drugs, notably decarbonize and its prod rug temozolomide, until to the emergence of immunotherapy and targeted therapy. Texans, vinka alkaloids, and platinum agents were also utilised, albeit less frequently. In the era of chemotherapy, the prognosis for metastatic melanoma patients was grim. The most prevalent melanoma subtypes, their distinctive molecular profiles, and the selective targeted therapies-such as immunotherapy and selective BRAF and MEK inhibitors—that have improved the prognosis and outcomes for thousands of patients-are all included in the present review.One of the most prevalent cancers, melanoma has a significant fatality risk if it is not caught early. Recent research on deep learning techniques demonstrates promising outcomes in the creation of computer-aided diagnosis for precise disease identification. The body of research supporting novel melanoma therapies is growing quickly. This may not always be reflected in the advice provided right now. The widely used 2015 National Institute for Health and Care Excellence (NICE) guideline for melanoma has recently been updated, according to a UK-based expert consensus statement published in JPRAS (NG14). We sought to evaluate NG14’s quality in comparison to all subsequent melanoma recommendations. Over the past ten years, there have been notable advancements in the treatment of melanoma In addition to reviewing the most recent clinical studies that will be useful in the near future; we explain historical patterns in the treatment of this condition in this article. Advanced melanoma was traditionally treated with chemotherapeutic drugs, notably decarbonize and its prod rug temozolomide, until to the emergence of immunotherapy and targeted therapy. Texans, vinka alkaloids, and platinum agents were also utilised, albeit less frequently. In the era of chemotherapy, the prognosis for metastatic melanoma patients was grim. The most prevalent melanoma subtypes, their distinctive molecular profiles, and the selective targeted therapies-such as immunotherapy and selective BRAF and MEK inhibitors—that have improved the prognosis and outcomes for thousands of patients-are all included in the present review.

Keywords

skin cancer• lentiginous melanoma• desmoplastic melanoma• nodular melanoma• second cancer risk• superficial spreading melanoma are among the cancers that can develop

Abbreviations: UV: Ultraviolet• miRNA: microRNA• DOCK2: dedicator of cytokinesis 2• NICE: National Institute for Health and Care Excellence

Introduction

One of the most dangerous conditions that endanger human health is malignant tumours. The frequency of malignant tumours has markedly increased in recent years. Melanoma has the highest level of malignancy among malignant tumours and is more prone than other forms of skin cancer to invade adjacent tissues and spread to other areas of the body. Chemotherapy and biotherapy are frequent cancer treatment options because there aren’t many distinct therapeutic targets [1]. However, clinical treatment frequently leads to cancer cells being resistant to these medicines, which results in tumor recurrence. Studies have increasingly indicated that tumor recurrence and treatment resistance are intimately related to cancer stem cells. Self-renewal, high proliferative and drug-resistant characteristics are present in cancer stem cells. A number of regulatory mechanisms of gene expression may be the root cause of these particular traits of cancer stem cells[2]. It is generally recognized that post-transcriptional modification plays a significant role in controlling how genes are expressed. RNA editing and microRNA (miRNA) are two examples of key posttranscriptional regulatory mechanisms [3].

Adenosine deaminize acting on RNA (ADAR) editing enzyme-catalyzed A (adenosine) to I (Inosine) RNA editing is the most common RNA-editing mechanism in animals. Angiogenesis is a significant characteristic of malignancies. It is possible for cancer cells to enter the bloodstream, move through the blood arteries, and develop metastatic tumors in different areas of the body. According to earlier research, arteries have the highest levels of RNA editing, which suggests that RNA editing is crucial to the growth of malignancies. To stop tumorigenicity during carcinogenesis, ADAR2-induced RNA editing of many genes can modify the way tumor cells behave. The oncogene PODXL, which produces the podocyte marker-like protein (PODXL), can be edited by ADAR2 to stop the growth of tumors. 19 Breast cancers can be prevented by the modified GABA receptor cell invasion and metastasis.

Evidence-based conclusions show that RNA editing and miRNAs are crucial to cancer. Clarifying the consequences of miRNAmediated regulation of RNA editing on cancer stem cells is therefore crucial. Our study described miR-17, which was supposed to target ADAR2 in order to remedy this problem. The findings showed that miR- 17 suppressed the stemness of melanoma stem cells by preventing ADAR2-mediated dedicator of cytokinesis 2 (DOCK2) mRNA editing. Among skin tumors, melanoma is a malignant tumor with the worst clinical symptoms and highest fatality rate. Since the early 1970s, the prevalence of melanoma has increased in mainly white populations. The factors influencing the prevalence of melanoma disease have dramatically changed during the past three decades. The huge increase in ultraviolet (UV) exposure caused by changes in leisure-time activities, such as prolonged sun exposure and indoor tanning, has led to an increase in melanoma development. Due to the large burden of melanoma, even though many nations have undertaken public prevention efforts like the Sun Smart programmes and skin cancer screening campaign, their long-term effects are still uncertain in the coming years [4]. The burden of melanoma has changed significantly over the world as a result of variations in risk factors and preventative initiatives between nations and regions. In an emergency room situation, uveal melanoma might be challenging to identify. Patients may exhibit a range of symptoms that are comparable to those of other intraocular illnesses, from serious and vision-threatening conditions to benign conditions. Retinal detachment is one of the most frequent and dangerous reasons for sudden vision loss. This may manifest as an abrupt loss of vision, which may be painful or not, as well as flashes and floaters in the eye. Retinal detachment can take many distinct forms [5].

Material and Methods

We carried out a thorough search of PubMed, Medline, and online clinical practice guideline databases to locate melanoma guidelines that suggested adjuvant therapy, radiation, surgical management, or follow-up care between July 29, 2015, and August 23, 2021. Using the Appraisal of Guidelines for Research & Evaluation Instrument II (AGREE II) evaluation tool, which evaluates six areas of guideline development, three writers independently, evaluated the effectiveness of the identified guidelines. Kendall’s coefficient of concordance was used to evaluate the reliability of the inter-raters (W) [6].

Results

With excellent concordance, 29 guidelines were included and scored (Kendall’s W for overall guideline score 0.88, p0.001). Overall, the melanoma recommendations received good marks for “Scope and purpose” and “Clarity of presentation,” but received mediocre marks for “Applicability.” The NICE melanoma guideline (NG14) received the highest overall ratings.

There was no over fitting issue with the suggested procedure. Over fitting is a problem when the model produced fits the training data too well and lacks the capacity to generalize properly, leading to low accuracy when applied to fresh data. Every time the deep learning model is trained, a validation step can be carried out in order to check for over fitting. During the validation procedure, validation data that is not present in the training data is used to test the network with the newly updated weights. In this study, the graph of the loss and accuracy values during the proposed method’s training process on the ISIC-Archive dataset is presented. The validation data that we use are data from the testing, and the loss and accuracy values for training data and validation data in each iteration of the training process are graphed [7]. This graph can be used to identify over fitting. An over fitting model’s defining feature is that it performs well when categorizing training data but poorly when categorizing new data, such as validation data. As a result, an over fit model typically sees a decrease in the training loss value but an increase in the validation loss value as the training process progresses[8]. Over the course of the training process, the training loss and validation loss might both continue to reduce. Thus, it can be said that the suggested model has acceptable generalizability and is not over fit. This is possible as a result of the suggested model’s use of a small epoch value and data augmentation, which raises the variability of the training data [9].

Discussion

In contrast to cutaneous melanomas, a PDM is a fairly uncommon subtype of melanoma that stands out for its great prognosis. Breslow depth may overstate the clinical aggressiveness of the entity, which could result in overtreatment. There is no good staging method or treatment guideline for this entity. Evidence-based findings demonstrate the significance of RNA editing and miRNAs in cancer. It is vital to understand how RNA editing is regulated by miRNAs and how this affects cancer stem cells. In order to address this issue, miR-17, which was the subject of our investigation, was designed to target ADAR2. The results demonstrated that miR-17 inhibited melanoma stem cells’ ability to edit their DNA by blocking ADAR2-mediated dedicator of cytokinesis 2 (DOCK2) mRNA editing. The malignant skin tumour with the worst clinical symptoms and greatest mortality rate is melanoma [10].

Conclusion

Since the publication of NG14, melanoma treatment has advanced, although the NICE melanoma guideline is still of superior quality than more current options. There is a need for the anticipated NG14 update in 2022. It is crucial that the practitioner is knowledgeable about a primary cutaneous melanoma. It merits a proper place in the existing AJCC system, and a therapy recommendation for this rare melanoma subtype with a comparatively good prognosis would be helpful.

Acknowledgement

None

Conflict of Interest

The authors declare that they have no conflicts of interest.

References

1. Hernandez-Ostiz S, Perez-Ramada MD, Ortiz B et al. 25-Hydroxyvitamin D in patients with melanoma and factors associated with inadequate levels. Actas Dermosifiliogr. 1079, 758-64 (2016).

Google Scholar Crossref, Indexed at

2. Brozyna A, Hoffman RM, Slominski AT et al. Relevance of vitamin D in melanoma development progression and therapy. Anticancer Res.  40, 473-89 (2020).

Google Scholar, Crossref, Indexed at

3. Newton-Bishop JA, Davies JR, Latheef F, et al. 25-Hydroxyvitamin D2/D3 levels and factors associated with systemic inflammation and melanoma survival in the Leeds Melanoma. Cohort Int J Cancer.  13612, 2890-99 (2015).

Google Scholar, Crossref, Indexed at

4. Lim A, Shayan R, Varigos G et al. High serum vitamin D level correlates with better prognostic  indicators in primary melanoma. J Dermatol.  59, 182-7 (2018).

Google Scholar, Crossref, Indexed at

5. Gerstenblith MR, Shi J, Landi MT et.al. Genome-wide association studies of pigmentation and skin cancer. Res. 23, 587-606 (2010).

Google Scholar, Crossref, Indexed at

6. Linos E, Swetter SM, Cockburn MG et.al. Clarke Increasing burden of melanoma in the United States. J Invest Dermatol. 129, 1666-74 (2009).

Google Scholar, Crossref, Indexed at

7. Pavan WJ, Sturm RA. The genetics of human skin and hair pigmentation Annu Re Genomics. Hum Genet. 20, 41-72 (2019).

Google Scholar, Crossref, Indexed at

8. Wray NR, Lee SH.  Impact of diagnostic misclassification on estimation of genetic correlations using genome-wide genotypes. Eur J Hum Genet. 20, 668-74 (2022).

Google Scholar, Crossref, Indexed at

9. Iorio MV, Croce CM.  MicroRNA dysregulation in cancer diagnostics, monitoring and therapeutics. .EMBO Mol Med. 4, 143-59 (2012).

Google Scholar, Crossref, Indexed at

10. Liu Y, Wondimu A, Yan S et.al. Tumor gangliosides accelerate murine tumor angiogenesis. Angiogenesis. 17, 563-71 (2014).

Google Scholar, Crossref, Indexed at