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Primary Anorectal Melanomas Interest of Targeting C-KIT in Two Cases from a Series of 11 Patients

Journal of Cancer Therapy 2014年第3期5卷 225-230页

作者： Karima Oualla Nawfel Mellas fatimazahra el’mrabet Samia Arifi Afaf Amarti Khalid Ait Taleb Siham Tizniti Omar elmesbahi Department of Medical Oncology Hassan II University Hospital Fez Morocco Department of Pathology Hassan II University Hospital Fez Morocco Department of Radiology Hassan II University Hospital Fez Morocco Department of Visceral Surgery Hassan II University Hospital Fez Morocco

Background: The anorectal location of melanomas is extremely rare (1% - 3% of all melanomas), and the prognosis remains poor because of the aggressiveness and the high metastatic potential of those tumors. The discovery that the KIT oncogene may be aberrantly activated in a subset of patients with anorectal melanoma creates a realm of possibility for the development of targeted molecular therapy. Aim: to show the epidemiologic, clinico-radiological, histological features and treatment management especially in patients with over-expression of C-KIT treated by Imatinib. Methods: It is a retrospective study conducted in the department of medical oncology at Hassan II University Hospital between January 2007 and January 2012, including all patients with histologically proven melanoma of the anorectal area. Results: 11 cases were collected, with slight female predominance. Nine patients were metastatic at the moment of diagnosis, and only two with local stage, but evolution was marked by local and distant recurrence less than 12 months after abdo-minoperineal resection. First line of chemotherapy was based mainly on paclitaxel, carboplatine and dacarbazine. Response was modest with only 3 partial responses, 4 patients with disease stability, and 4 patients with disease progression. Two patients, with over expression of C-KIT, received Imatinib as second line of treatment with significant improvement of symptoms and radiological response reaching 50%. Seven patients died with a median survival of 11 months from diagnosis to the date of death. Conclusion: Primary anorectal melanomas are very rare, with high aggressiveness and poor prognosis. Treatment management is still a big challenge given to the modest efficacy of conventional chemotherapy. Better understanding of carcinogenesis and signaling pathways will allow development of new targeted therapies.

关键词： Melanoma Anorectal Area Surgery Chemotherapy C-KIT Imatinib

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Primary Melanoma of the Vagina Treated by Imatinib: Case Report

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Journal of Cancer Therapy 2013年第7期4卷 1158-1161页

作者： Karima Oualla fatimazahra el’mrabet Hind elfatemi Samia Arifi Nawfel Mellas Abdelaziz Banani Siham Tizniti Afaf Amarti Omar elmesbahi Department of Medical Oncology Hassan II University Hospital Fez Morocco Department of Pathology Hassan II University Hospital Fez Morocco

Melanoma of the vagina is a rare lesion. It results from the malignant transformation of ectopic melanocytes occurring in post-menopause. The CKIT is expressed in 36% of cases in addition to melanoma markers. Prognosis is poor especially for inoperable and disseminated forms despite systemic therapy. Treatment with Imatinib is an option in cases of metastatic mucosal melanoma with CKIT mutation or amplification. We report the case of post-menopausal women, treated at Hassan II University Hospital, diagnosed with metastatic melanoma of the vagina, that didn’t respond to first line of chemotherapy, and received Imatinib as second line of treatment, with good clinical response and durable stability at radiological assessment.

关键词： Mucosal Melanoma Vagina CKIT Imatinib

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