Melanoma, Version 2.2013

The NCCN Guidelines for Melanoma provide multidisciplinary recommendations on the clinical management of patients with melanoma. This NCCN Guidelines Insights report highlights notable recent updates. Foremost of these is the exciting addition of the novel agents ipilimumab and vemurafenib for treatment of advanced melanoma. The NCCN panel also included imatinib as a treatment for KIT-mutated tumors and pegylated interferon alfa-2b as an option for adjuvant therapy. Also important are revisions to the initial stratification of early-stage lesions based on the risk of sentinel lymph node metastases, and revised recommendations on the use of sentinel lymph node biopsy for low-risk groups. Finally, the NCCN panel reached clinical consensus on clarifying the role of imaging in the workup of patients with melanoma. (JNCCN 2013;11:395–407) Melanoma, Version 2.2013 © JNCCN—Journal of the National Comprehensive Cancer Network | Volume 11 Number 4 | April 2013 396 NCCN Guidelines Insights C E NCCN: Continuing Education Accreditation Statement This activity has been designated to meet the educational needs of physicians, nurses, and pharmacists involved in the management of patients with cancer. There is no fee for this article. The National Comprehensive Cancer Network (NCCN) is accredited by the ACCME to provide continuing medical education for physicians. NCCN designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. NCCN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center`s Commission on Accreditation. This activity is approved for 1.0 contact hour. Approval as a provider refers to recognition of educational activities only; accredited status does not imply endorsement by NCCN or ANCC of any commercial products discussed/displayed in conjunction with the educational activity. Kristina M. Gregory, RN, MSN, OCN, is our nurse planner for this educational activity. National Comprehensive Cancer Network is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. NCCN designates this continuing education activity for 1.0 contact hour(s) (0.1 CEUs) of continuing education credit in states that recognize ACPE accredited providers. This is a knowledgebased activity. UAN: 0836-0000-13-012-H01-P All clinicians completing this activity will be issued a certificate of participation. To participate in this journal CE activity: 1) review the learning objectives and author disclosures; 2) study the education content; 3) take the posttest with a 70% minimum passing score and complete the evaluation at http://education.nccn.org/node/16295; and 4) view/print certificate. Release date: April 11, 2013; Expiration date: April 11, 2014 Learning Objectives: Upon completion of this activity, participants will be able to: • Integrate into professional practice the updates to NCCN Guidelines for Melanoma • Describe the rationale behind the decision-making process for developing the NCCN Guidelines for Melanoma EDITOR: Kerrin M. Green, MA, Assistant Managing Editor, JNCCN—Journal of the National Comprehensive Cancer Network, has disclosed that she has no relevant financial relationships. CE AUTHORS: Nicole B. Harrold, BS, Manager, Continuing Education and Grants, has disclosed that she has no relevant financial relationships. Kristina M. Gregory, RN, MSN, OCN, Vice President, Clinical Information Operations, has disclosed that she has no relevant financial relationships. James Prazak, RPh, Assistant Director, Continuing Education and Grants, has disclosed the following relationships with commercial interests: Bristol-Myers Squibb Company: Pension; Pfizer, Inc: Stockholder; United Healthcare Group: Stockholder; Johnson & Johnson: Stockholder. Maria Ho, PhD, Oncology Scientist/Senior Medical Writer, has disclosed that she has no relevant financial relationships. Disclosure of Affiliations and Significant Relationships The following authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products or devices discussed in this report or their competitors: Dr. Andtbacka, Dr. Anker, Dr. Bichakjian, Dr. Carson, Dr. DiMaio, Dr. Fleming, Ms. Guild, Dr. Halpern, Dr. Kelley, Dr. Lange, Dr. Lind, Dr. Olszanski, Dr. Pruitt, Dr. Swetter, Dr. Tanabe, Dr. Trisal, and Dr. Urist. The authors listed below have disclosed the following financial interests, arrangements, affiliations, or commercial interests. Dr. Coit: Member of the Data Safety Monitoring Board for MSLT-II. Dr. Daud: Research support from Abbott Laboratories; GlaxoSmithKline plc; Merck & Co., Inc.; Pfizer Inc.; Roche Laboratories, Inc.; Schering-Plough Corporation; and Wyeth Pharmaceuticals. Dr. Hodi: Research support from Bristol-Myers Squibb Company; Genentech, Inc.; Novartis Pharmaceuticals Corporation; Pfizer, Inc.; and Schering-Plough Corporation. Speaker bureau member for Bristol-Myers Squibb Company and Merck & Co., Inc. Dr. Khushalani: Advisory board and speaker bureau member for Prometheus. Dr. Kudchadkar: Investigator for Bristol-Myers Squibb Company; Genentech Inc.; and GlaxoSmithKline. Advisory board member for Genentech, Inc. Dr. Martini: PI for Electro-Optical Sciences Inc. Advisory board member for Unilever plc. Dr. Ross: Speaker bureau member for Genentech, Inc.; Genomic Health, Inc.; GlaxoSmithKline; and Merck & Co., Inc. Advisory board member for Merck & Co. Dr. Thompson: Investigator for Bristol-Myers Squibb Company; Genentech, Inc.; GlaxoSmithKline; ImClone Systems Incorporated; Novartis Pharmaceuticals Corporation; and Altor Biosciences. Consultant for Bristol-Myers Squibb Company and Genentech, Inc. The NCCN Guidelines Staff have no conflicts to disclose. Supported by educational grants from Eisai, Inc.; Millennium: The Takeda Oncology Company; Teva Pharmaceuticals; Bayer HealthCare Pharmaceuticals Inc.; Celgene Corporation; Endo Pharmaceuticals and HealthTronics; Genentech; and ARIAD Pharmaceuticals, Inc.