CONCLUSIONS

SNMM is a rare disease that harbors a poor prognosis. Distant metastasis is the most common cause of treatment failure. The variability of the disease and the emergence of new treatment modalities necessitate an MDT approach for the optimal management of treatment choice, treatment side effects, and follow-up.

Surgery remains the mainstay of treatment in patients with SNMM. Adjuvant RT seems to improve local control, without a substantial effect on overall survival. Chemotherapy does not play a significant role as a primary treatment, while immunotherapy may confer survival benefit to patients with metastatic disease.


Continue Reading

Acknowledgment

Cindy Cohen is thanked for her editorial assistance.

Disclosure

The authors report no conflicts of interest in this work.

References

1. Gal TJ, Silver N, Huang B. Demographics and treatment trends in sinonasal mucosal melanoma. Laryngoscope. 2011;121(9):2026–2033. doi:10.1002/lary.21925

2. Gilain L, Houette A, Montalban A, Mom T, Saroul N. Mucosal melanoma of the nasal cavity and paranasal sinuses. Eur Ann Otorhinolaryngol Head Neck Dis. 2014;131(6):365–369. doi:10.1016/j.anorl.2013.11.004

3. Ganti A, Raman A, Shay A, et al. Treatment modalities in sinonasal mucosal melanoma: a national cancer database analysis. Laryngoscope. 2019. doi:10.1002/lary.27995

4. Jethanamest D, Vila PM, Sikora AG, Morris LGT. Predictors of survival in mucosal melanoma of the head and neck. Ann Surg Oncol. 2011;18(10):2748–2756. doi:10.1245/s10434-011-1685-4

5. Konuthula N, Khan MN, Parasher A, et al. The presentation and outcomes of mucosal melanoma in 695 patients. Int Forum Allergy Rhinol. 2017;7(1):99–105. doi:10.1002/alr.21831

6. Head and neck cancers. Available from: http://www.nccn.org. Accessed February 13, 2020.

7. Licitra L, Bossi P, Locati LD. A multidisciplinary approach to squamous cell carcinomas of the head and neck: what is new? Curr Opin Oncol. 2006;18(3):253–257. doi:10.1097/01.cco.0000219254.53091.35

8. Chan ATC, Gregoire V, Lefebvre J-L, et al. Nasopharyngeal cancer: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol off J Eur Soc Med Oncol. 2012;23 Suppl 7:vii83–5. doi:10.1093/annonc/mds266

9. Bergamini C, Locati L, Bossi P, et al. Does a multidisciplinary team approach in a tertiary referral centre impact on the initial management of head and neck cancer? Oral Oncol. 2016;54:54–57. doi:10.1016/j.oraloncology.2016.01.001

10. Shah JP, Gil Z. Current concepts in management of oral cancer–surgery. Oral Oncol. 2009;45(4–5):394–401. doi:10.1016/j.oraloncology.2008.05.017

11. Marur S, Forastiere AA. Head and neck cancer: changing epidemiology, diagnosis, and treatment. Mayo Clin Proc. 2008;83(4):489–501. doi:10.4065/83.4.489

12. Mazzaferro V, Majno P. Principles for the best multidisciplinary meetings. Lancet Oncol. 2011;12(4):323–325. doi:10.1016/S1470-2045(11)70010-9

13. Lewis CM, Hessel AC, Roberts DB, et al. Prereferral head and neck cancer treatment: compliance with national comprehensive cancer network treatment guidelines. Arch Otolaryngol Head Neck Surg. 2010;136(12):1205–1211. doi:10.1001/archoto.2010.206

14. Fleissig A, Jenkins V, Catt S, Fallowfield L. Multidisciplinary teams in cancer care: are they effective in the UK? Lancet Oncol. 2006;7(11):935–943. doi:10.1016/S1470-2045(06)70940-8

15. Forrest LM, McMillan DC, McArdle CS, Dunlop DJ. An evaluation of the impact of a multidisciplinary team, in a single centre, on treatment and survival in patients with inoperable non-small-cell lung cancer. Br J Cancer. 2005;93(9):977–978. doi:10.1038/sj.bjc.6602825

16. Chang JH, Vines E, Bertsch H, et al. The impact of a multidisciplinary breast cancer center on recommendations for patient management: the University of Pennsylvania experience. Cancer. 2001;91(7):1231–1237. doi:10.1002/1097-0142(20010401)91:7<1231::aid-cncr1123>3.0.co;2-k

17. Wheless SA, McKinney KA, Zanation AM. A prospective study of the clinical impact of a multidisciplinary head and neck tumor board. Otolaryngol Head Neck Surg. 2010;143(5):650–654. doi:10.1016/j.otohns.2010.07.020

18. Birchall M, Bailey D, King P. Effect of process standards on survival of patients with head and neck cancer in the south and west of England. Br J Cancer. 2004;91(8):1477–1481. doi:10.1038/sj.bjc.6602118

19. Gabel M, Hilton NE, Nathanson SD. Multidisciplinary breast cancer clinics. Do they work? Cancer. 1997;79(12):2380–2384. doi:10.1002/(ISSN)1097-0142

20. Sidhom MA, Poulsen MG. Multidisciplinary care in oncology: medicolegal implications of group decisions. Lancet Oncol. 2006;7(11):951–954. doi:10.1016/S1470-2045(06)70942-1

21. Patrick RJ, Fenske NA, Messina JL. Primary mucosal melanoma. J Am Acad Dermatol. 2007;56(5):828–834. doi:10.1016/J.JAAD.2006.06.017

22. Curtin JA, Busam K, Pinkel D, Bastian BC. Somatic activation of KIT in distinct subtypes of melanoma. J Clin Oncol. 2006;24(26):4340–4346. doi:10.1200/JCO.2006.06.2984

23. Torres-Cabala CA, Wang W-L, Trent J, et al. Correlation between KIT expression and KIT mutation in melanoma: a study of 173 cases with emphasis on the acral-lentiginous/mucosal type. Mod Pathol. 2009;22(11):1446–1456. doi:10.1038/modpathol.2009.116

24. Zebary A, Jangard M, Omholt K, Ragnarsson-Olding B, Hansson J. KIT, NRAS and BRAF mutations in sinonasal mucosal melanoma: a study of 56 cases. Br J Cancer. 2013;109(3):559–564. doi:10.1038/bjc.2013.373

25. Turri-Zanoni M, Medicina D, Lombardi D, et al. Sinonasal mucosal melanoma: molecular profile and therapeutic implications from a series of 32 cases. Head Neck. 2013;35(8):1066–1077. doi:10.1002/hed.23079

26. Carvajal RD, Antonescu CR, Wolchok JD, et al. KIT as a therapeutic target in metastatic melanoma. JAMA. 2011;305(22):2327. doi:10.1001/jama.2011.746

27. Bastian BC. Understanding the progression of melanocytic neoplasia using genomic analysis: from fields to cancer. Oncogene. 2003;22(20):3081–3086. doi:10.1038/sj.onc.1206463

28. Wu H, Goel V, Haluska FG. PTEN signaling pathways in melanoma. Oncogene. 2003;22(20):3113–3122. doi:10.1038/sj.onc.1206451

29. Soares C, Melo de Lima Morais T, Carlos R, et al. Phosphorylated Akt1 expression is associated with poor prognosis in cutaneous, oral and sinonasal melanomas. Oncotarget. 2018;9(99):37291–37304. doi:10.18632/oncotarget.26458

30. Cho JH, Robinson JP, Arave RA, et al. AKT1 activation promotes development of melanoma metastases. Cell Rep. 2015;13(5):898–905. doi:10.1016/j.celrep.2015.09.057

31. van Dijk M, Sprenger S, Rombout P, et al. Distinct chromosomal aberrations in sinonasal mucosal melanoma as detected by comparative genomic hybridization. Genes Chromosom Cancer. 2003;36(2):151–158. doi:10.1002/gcc.10156

32. Woodman SE, Davies MA. Targeting KIT in melanoma: a paradigm of molecular medicine and targeted therapeutics. Biochem Pharmacol. 2010;80(5):568–574. doi:10.1016/J.BCP.2010.04.032

33. Jangard M, Zebary A, Ragnarsson-Olding B, Hansson J. TERT promoter mutations in sinonasal malignant melanoma: a study of 49 cases. Melanoma Res. 2015;25(3):185–188. doi:10.1097/CMR.0000000000000148

34. Su DM, Zhang Q, Wang X, et al. Two types of human malignant melanoma cell lines revealed by expression patterns of mitochondrial and survival-apoptosis genes: implications for malignant melanoma therapy. Mol Cancer Ther. 2009;8(5):1292–1304. doi:10.1158/1535-7163.MCT-08-1030

35. Soares CD, de Lima Morais TM, Mariano FV, et al. Expression of mitochondrial dynamics markers during melanoma progression: comparative study of head and neck cutaneous and mucosal melanomas. J Oral Pathol Med off Publ Int Assoc Oral Pathol Am Acad Oral Pathol. 2019;48(5):373–381. doi:10.1111/jop.12855

36. Soares CD, de Lima Morais TM, Carlos R, et al. Prognostic importance of mitochondrial markers in mucosal and cutaneous head and neck melanomas. Hum Pathol. 2019;85:279–289. doi:10.1016/j.humpath.2018.11.009

37. Lombardi D, Bottazzoli M, Turri-Zanoni M, et al. Sinonasal mucosal melanoma: a 12-year experience of 58 cases. Head Neck. 2016;38 Suppl 1:E1737–45. doi:10.1002/hed.24309

38. Swegal W, Koyfman S, Scharpf J, et al. Endoscopic and open surgical approaches to locally advanced sinonasal melanoma: comparing the therapeutic benefits. JAMA Otolaryngol Head Neck Surg. 2014;140(9):840–845. doi:10.1001/jamaoto.2014.1321

39. Amit M, Abergel A, Fliss DM, Gil Z. The clinical importance of quality-of-life scores in patients with skull base tumors: a meta-analysis and review of the literature. Curr Oncol Rep. 2012;14(2):175–181. doi:10.1007/s11912-012-0222-3

40. Abergel A, Cavel O, Margalit N, Fliss DM, Gil Z. Comparison of quality of life after transnasal endoscopic vs open skull base tumor resection. Arch Otolaryngol Head Neck Surg. 2012;138(2):142–147. doi:10.1001/archoto.2011.1146

41. Cavel O, Abergel A, Margalit N, Fliss DM, Gil Z. Quality of life following endoscopic resection of skull base tumors. J Neurol Surg B Skull Base. 2012;73(2):112–116. doi:10.1055/s-0032-1301392

42. Gil Z, Fliss DM. Contemporary management of head and neck cancers. Isr Med Assoc J. 2009;11(5):296–300.

43. Tajudeen BA, Vorasubin N, Sanaiha Y, Palma-Diaz MF, Suh JD, Wang MB. Sinonasal mucosal melanoma: 20-year experience at a tertiary referral center. Int Forum Allergy Rhinol. 2014;4(7):592–597. doi:10.1002/alr.21324

44. Lee SP, Shimizu KT, Tran LM, Juillard G, Calcaterra TC. Mucosal melanoma of the head and neck: the impact of local control on survival. Laryngoscope. 1994;104(2):121–126. doi:10.1288/00005537-199402000-00001

45. Penel N, Mallet Y, Mirabel X, Van JT, Lefebvre J-L. Primary mucosal melanoma of head and neck: prognostic value of clear margins. Laryngoscope. 2006;116(6):993–995. doi:10.1097/01.mlg.0000217236.06585.a9

46. Amit M, Na’ara S, Hanna EY. Contemporary treatment approaches to sinonasal mucosal melanoma. Curr Oncol Rep. 2018;20(2):10. doi:10.1007/s11912-018-0660-7

47. Gil Z, Carlson DL, Gupta A, et al. Patterns and incidence of neural invasion in patients with cancers of the paranasal sinuses. Arch Otolaryngol Head Neck Surg. 2009;135(2):173–179. doi:10.1001/archoto.2008.525

48. Amit M, Tam S, Abdelmeguid AS, et al. Approaches to regional lymph node metastasis in patients with head and neck mucosal melanoma. Cancer. 2018;124(3):514–520. doi:10.1002/cncr.31083

49. Low CM, Price DL, Moore EJ, et al. Nodal and distant metastases in sinonasal mucosal melanoma: a population-based analysis. Laryngoscope. 2019. doi:10.1002/lary.28065

50. Chapman PB, Einhorn LH, Meyers ML, et al. Phase III multicenter randomized trial of the dartmouth regimen versus dacarbazine in patients with metastatic melanoma. J Clin Oncol. 1999;17(9):2745. doi:10.1200/JCO.1999.17.9.2745

51. Tyrrell H, Payne M. Combatting mucosal melanoma: recent advances and future perspectives. Melanoma Manag. 2018;5(3):MMT11. doi:10.2217/mmt-2018-0003

52. Amit M, Tam S, Abdelmeguid AS, et al. Role of adjuvant treatment in sinonasal mucosal melanoma. J Neurol Surg B Skull Base. 2017;78(6):512–518. doi:10.1055/s-0037-1604350

53. Spencer KR, Mehnert JM. Mucosal Melanoma: Epidemiology, Biology and Treatment. Cham: Springer; 2016. 295–320. doi:10.1007/978-3-319-22539-5_13

54. Cheng Y-F, Lai -C-C, Ho C-Y, Shu C-H, Lin C-Z. Toward a Better Understanding of Sinonasal Mucosal Melanoma: Clinical Review of 23 Cases. Vol. 70. 2007. doi:10.1016/S1726-4901(09)70296-5

55. Legha S, Ring S, Eton O, Bedikian A, Plager C, Papadopoulos N. Development and results of biochemotherapy in metastatic melanoma: the university of texas MD anderson cancer center experience. Cancer J Sci Am. 1977;3:S9–S15.

56. Keilholz U, Goey SH, Punt CJ, et al. Interferon alfa-2a and interleukin-2 with or without cisplatin in metastatic melanoma: a randomized trial of the European Organization for Research and Treatment of Cancer Melanoma Cooperative Group. J Clin Oncol. 1997;15(7):2579–2588. doi:10.1200/JCO.1997.15.7.2579

57. Atkins MB, Hsu J, Lee S, et al. Phase III trial comparing concurrent biochemotherapy with cisplatin, vinblastine, dacarbazine, interleukin-2, and interferon alfa-2b with cisplatin, vinblastine, and dacarbazine alone in patients with metastatic malignant melanoma (E3695): a trial coordinated by the Eastern Cooperative Oncology Group. J Clin Oncol. 2008;26(35):5748–5754. doi:10.1200/JCO.2008.17.5448

58. Flaherty LE, Othus M, Atkins MB, et al. Southwest Oncology Group S0008: a phase III trial of high-dose interferon Alfa-2b versus cisplatin, vinblastine, and dacarbazine, plus interleukin-2 and interferon in patients with high-risk melanoma–an intergroup study of cancer and leukemia Group B, Children’s Oncology Group, Eastern Cooperative Oncology Group, and Southwest Oncology Group. J Clin Oncol. 2014;32(33):3771–3778. doi:10.1200/JCO.2013.53.1590

59. Lian B, Si L, Cui C, et al. Phase II randomized trial comparing high-dose IFN- 2b with temozolomide plus cisplatin as systemic adjuvant therapy for resected mucosal melanoma. Clin Cancer Res. 2013;19(16):4488–4498. doi:10.1158/1078-0432.CCR-13-0739

60. Hodi FS, Corless CL, Giobbie-Hurder A, et al. Imatinib for melanomas harboring mutationally activated or amplified kit arising on mucosal, acral, and chronically sun-damaged skin. J Clin Oncol. 2013;31(26):3182–3190. doi:10.1200/JCO.2012.47.7836

61. Woodman SE, Trent JC, Stemke-Hale K, et al. Activity of dasatinib against L576P KIT mutant melanoma: molecular, cellular, and clinical correlates. Mol Cancer Ther. 2009;8(8):2079–2085. doi:10.1158/1535-7163.MCT-09-0459

62. Ascierto PA, Schadendorf D, Berking C, et al. MEK162 for patients with advanced melanoma harbouring NRAS or Val600 BRAF mutations: a non-randomised, open-label Phase 2 study. Lancet Oncol. 2013;14(3):249–256. doi:10.1016/S1470-2045(13)70024-X

63. Larkin J, Del Vecchio M, Ascierto PA, et al. Vemurafenib in patients with BRAFV600 mutated metastatic melanoma: an open-label, multicentre, safety study. Lancet Oncol. 2014;15(4):436–444. doi:10.1016/S1470-2045(14)70051-8

64. Chapman PB, Hauschild A, Robert C, et al. Improved survival with vemurafenib in melanoma with BRAF V600E mutation. N Engl J Med. 2011;364(26):2507–2516. doi:10.1056/NEJMoa1103782

65. Flaherty K, Arenberger P, Ascierto PA, et al. NEMO: a Phase 3 trial of binimetinib (MEK162) versus dacarbazine in patients with untreated or progressed after first-line immunotherapy unresectable or metastatic NRAS -mutant cutaneous melanoma. J Clin Oncol. 2014;32(15_suppl):TPS9102–TPS9102. doi:10.1200/jco.2014.32.15_suppl.tps9102

66. Dummer R, Schadendorf D, Ascierto PA, et al. Binimetinib versus dacarbazine in patients with advanced NRAS -mutant melanoma (NEMO): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2017;18(4):435–445. doi:10.1016/S1470-2045(17)30180-8

67. Hodi FS, O’Day SJ, McDermott DF, et al. Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med. 2010;363(8):711–723. doi:10.1056/NEJMoa1003466

68. Robert C, Thomas L, Bondarenko I, et al. Ipilimumab plus dacarbazine for previously untreated metastatic melanoma. N Engl J Med. 2011;364(26):2517–2526. doi:10.1056/NEJMoa1104621

69. Schadendorf D, Hodi FS, Robert C, et al. Pooled analysis of long-term survival data from Phase II and Phase III trials of ipilimumab in unresectable or metastatic melanoma. J Clin Oncol. 2015;33(17):1889–1894. doi:10.1200/JCO.2014.56.2736

70. Robert C, Long GV, Brady B, et al. Nivolumab in previously untreated melanoma without BRAF mutation. N Engl J Med. 2015;372(4):320–330. doi:10.1056/NEJMoa1412082

71. Weber JS, D’Angelo SP, Minor D, et al. Nivolumab versus chemotherapy in patients with advanced melanoma who progressed after anti-CTLA-4 treatment (CheckMate 037): a randomised, controlled, open-label, phase 3 trial. Lancet Oncol. 2015;16(4):375–384. doi:10.1016/S1470-2045(15)70076-8

72. D’Angelo SP, Larkin J, Sosman JA, et al. Efficacy and safety of nivolumab alone or in combination with ipilimumab in patients with mucosal melanoma: a pooled analysis. J Clin Oncol. 2017;35(2):226–235. doi:10.1200/JCO.2016.67.9258

73. Robert C, Schachter J, Long GV, et al. Pembrolizumab versus ipilimumab in advanced melanoma. N Engl J Med. 2015;372(26):2521–2532. doi:10.1056/NEJMoa1503093

74. Ribas A, Puzanov I, Dummer R, et al. Pembrolizumab versus investigator-choice chemotherapy for ipilimumab-refractory melanoma (KEYNOTE-002): a randomised, controlled, phase 2 trial. Lancet Oncol. 2015;16(8):908–918. doi:10.1016/S1470-2045(15)00083-2

75. Redman JM, Gibney GT, Atkins MB. Advances in immunotherapy for melanoma. BMC Med. 2016;14(1):20. doi:10.1186/s12916-016-0571-0

76. Samstein RM, Carvajal RD, Postow MA, et al. Localized sinonasal mucosal melanoma: outcomes and associations with stage, radiotherapy, and positron emission tomography response. Head Neck. 2016;38(9):1310–1317. doi:10.1002/hed.24435

77. Li W, Yu Y, Wang H, Yan A, Jiang X. Evaluation of the prognostic impact of postoperative adjuvant radiotherapy on head and neck mucosal melanoma: a meta-analysis. BMC Cancer. 2015;15:758. doi:10.1186/s12885-015-1750-7

78. Crippen MM, Kilic S, Eloy JA. Updates in the management of sinonasal mucosal melanoma. Curr Opin Otolaryngol Head Neck Surg. 2018;26(1):52–57. doi:10.1097/MOO.0000000000000428

79. Zenda S, Kawashima M, Nishio T, et al. Proton beam therapy as a nonsurgical approach to mucosal melanoma of the head and neck: a pilot study. Int J Radiat Oncol Biol Phys. 2011;81(1):135–139. doi:10.1016/j.ijrobp.2010.04.071

80. Yanagi T, Mizoe J-E, Hasegawa A, et al. Mucosal malignant melanoma of the head and neck treated by carbon ion radiotherapy. Int J Radiat Oncol Biol Phys. 2009;74(1):15–20. doi:10.1016/j.ijrobp.2008.07.056

81. Mizoe J-E, Hasegawa A, Jingu K, et al. Results of carbon ion radiotherapy for head and neck cancer. Radiother Oncol. 2012;103(1):32–37. doi:10.1016/j.radonc.2011.12.013

82. Fuji H, Yoshikawa S, Kasami M, et al. High-dose proton beam therapy for sinonasal mucosal malignant melanoma. Radiat Oncol. 2014;9:162. doi:10.1186/1748-717X-9-162

83. Douglas CM, Malik T, Swindell R, Lorrigan P, Slevin NJ, Homer JJ. Mucosal melanoma of the head and neck: radiotherapy or surgery? J Otolaryngol Head Neck Surg. 2010;39(4):385–392.

84. Krengli M, Jereczek-Fossa BA, Kaanders JHAM, Masini L, Beldi D, Orecchia R. What is the role of radiotherapy in the treatment of mucosal melanoma of the head and neck? Crit Rev Oncol Hematol. 2008;65(2):121–128. doi:10.1016/j.critrevonc.2007.07.001

85. Bachar G, Loh KS, O’Sullivan B, et al. Mucosal melanomas of the head and neck: experience of the Princess Margaret Hospital. Head Neck. 2008;30(10):1325–1331. doi:10.1002/hed.20878

86. Amit M, Tam S, Abdelmeguid AS, et al. Patterns of treatment failure in patients with sinonasal mucosal melanoma. Ann Surg Oncol. 2018;25(6):1723–1729. doi:10.1245/s10434-018-6465-y

87. Moreno MA, Roberts DB, Kupferman ME, et al. Mucosal melanoma of the nose and paranasal sinuses, a contemporary experience from the M. D. Anderson Cancer Center. Cancer. 2010;116(9):NA–NA. doi:10.1002/cncr.24976

88. Clifton N, Harrison L, Bradley PJ, Jones NS. Malignant melanoma of nasal cavity and paranasal sinuses: report of 24 patients and literature review. J Laryngol Otol. 2011;125(5):479–485. doi:10.1017/S0022215110002720

89. Thariat J, Bolle S, Demizu Y, et al. New techniques in radiation therapy for head and neck cancer. Anticancer Drugs. 2011;22(7):596–606. doi:10.1097/CAD.0b013e328340fd2b

90. Lund VJ, Chisholm EJ, Howard DJ, Wei WI. Sinonasal malignant melanoma: an analysis of 115 cases assessing outcomes of surgery, postoperative radiotherapy and endoscopic resection. Rhinology. 2012;50(2):203–210. doi:10.4193/Rhino11.267

91. Sun C-Z, Li Q-L, Hu Z-D, Jiang Y-E, Song M, Yang A-K. Treatment and prognosis in sinonasal mucosal melanoma: a retrospective analysis of 65 patients from a single cancer center. Head Neck. 2014;36(5):675–681. doi:10.1002/hed.23355

92. Clair JM, Arshi A, Tajudeen B, Abemayor E, St John M. Epidemiology and treatment of lacrimal gland tumors. JAMA Otolaryngol Neck Surg. 2014;140(12):1110. doi:10.1001/jamaoto.2014.2846

93. Stanimirov Rossi O, Vital D, Soyka MB, Roth TN, Huber GF, Holzmann D. Multilocular sinonasal malignant melanoma: a poor prognostic subgroup? Eur Arch Oto Rhino Laryngol. 2015;272(1):123–129. doi:10.1007/s00405-014-3098-z

94. Mochel MC, Duncan LM, Piris A, Kraft S. Primary mucosal melanoma of the sinonasal tract: a clinicopathologic and immunohistochemical study of thirty-two cases. Head Neck Pathol. 2015;9(2):236–243. doi:10.1007/s12105-014-0570-4

95. Meng X-J, Ao H-F, Huang W-T, et al. Impact of different surgical and postoperative adjuvant treatment modalities on survival of sinonasal malignant melanoma. BMC Cancer. 2014;14(1):608. doi:10.1186/1471-2407-14-608

96. Kim DW, Barcena E, Mehta UN, et al. Prolonged survival of a patient with metastatic leptomeningeal melanoma treated with BRAF inhibition-based therapy: a case report. BMC Cancer. 2015;15(1):400. doi:10.1186/s12885-015-1391-x

97. Plavc G, But-Hadžić J, Aničin A, Lanišnik B, Didanović V, Strojan P. Mucosal melanoma of the head and neck: a population-based study from Slovenia, 1985–2013. Radiat Oncol. 2016;11(1):137. doi:10.1186/s13014-016-0712-9

Source: OncoTargets and Therapy.
Originally published March 16, 2020.

READ FULL ARTICLE Curated publisher From Dovepress