DERMATOLOGY * MELANOMA
Prevention, Therapy and Genetic Mutations - Verona -
Dermatology
Melanoma Targeted Therapy
(target therapy or molecularly targeted therapy)
Dermatology and Skin Tumors
The Dermatology Division is committed to being a leader in patient care, education, and research. Our patient care includes services ranging from general dermatology to wound healing, and two affiliated specialty clinics.
It offers general dermatology services, dermatologic surgery, including surgical excisions and micrographic surgery, laser surgery, wound healing consultations, phototherapy, patch testing, pediatric dermatology, cutaneous melanoma treatment, and skin oncology. Its mission is to be a leader in teaching, research, and patient care related to skin diseases. The team is committed to education, generating new knowledge about healthy and diseased skin, and innovation, while maintaining the highest ethical standards and academic excellence.
The Department is affiliated with the Eurofins Genoma Group, Signatera, and Domus Salutis, which offers personalized counseling sessions on tumor genetic mutations and reconstructive plastic surgery.
Cure rates for Mohs surgery
Clinical studies have shown that Mohs micrographic surgery offers five-year cure rates of approximately 99% for primary basal cell carcinomas and 96% for recurrent basal cell carcinomas. Cure rates for squamous cell carcinomas are approximately 97%. These cure rates are significantly higher than those achieved with other methods of tumor removal or destruction.
Mohs surgery is preferred over other treatments for:
- Tumors on the face
- Tumors in other parts of the body that may be difficult to repair if too much tissue is removed
- Recurrent tumors (previously treated)
- Large tumors or tumors without clearly defined borders
- Tumors that appear aggressive under the microscope
Therapies for Cutaneous Melanoma
They depend on the stage of the disease, the molecular characteristics of the tumor (e.g., BRAF mutation), and the patient's general condition. Here's an updated overview.
๐ข 1. Surgery
It is the main treatment in the early stages.
- Wide surgical excision of melanoma with safety margins.
- Sentinel lymph node biopsy (in intermediate stages) to assess possible spread.
๐ In the early stages it can be curative.
๐ก 2. Immunotherapy
It stimulates the immune system to recognize and destroy tumor cells.
Main drugs:
- Nivolumab
- Pembrolizumab
- Ipilimumab
Usage:
- Adjuvant therapy (after stage III-IV surgery)
- Metastatic melanoma
- In some cases combination (Nivolumab Ipilimumab)
โ Significantly improved survival in advanced stages.
๐ต 3. Terapie mirate (Target Therapy)
Indicated in patients with BRAF mutation (approximately 40–50%).
Most used combinations:
- Dabrafenib Trametinib
- Vemurafenib Cobimetinib
๐ They work by selectively blocking tumor growth. ๐ Rapid responses, but resistance may develop over time.
๐ด 4. Radiotherapy
- Used in case of brain or bone metastases
- Sometimes after lymph node surgery
It is not primary therapy for early melanoma.
๐งช 5. Chemotherapy
Currently rarely used. It can be considered when immunotherapy and targeted therapies are ineffective.
๐ Stage-based therapy (simplified)
- Stage 0–I → Surgery
- Stage II → Surgery ± adjuvant immunotherapy
- Stage III → Surgery immunotherapy or targeted therapy
- Stage IV → Immunotherapy or targeted therapy ± surgery/radiotherapy
๐ฑ New perspectives
- Cell therapies (e.g. tumor-infiltrating lymphocytes)
- Therapeutic vaccines
- Innovative immunotherapy combinations
Melanoma Research and Clinical Trials
Many Oncogenoma Precision Oncology patients receive promising therapies through clinical trials. These studies are led by researchers at Fred Hutch and UW Medicine and aim to test new treatments or new approaches to existing ones. We have a wide variety of clinical trials for melanoma, including vaccine studies, immune cell therapies, and other immunotherapies.
Every advance in cancer treatment in recent years is the result of clinical trials. We offer more active clinical trials than any other center, which means more treatment options for patients like you.
Our multidisciplinary teams of experts provide care for all types of cancer, including cutting-edge therapies for difficult-to-treat tumors, CAR-T cell therapies, and clinical trials.
The difference between immunotherapy and targeted therapy in melanoma concerns the target of action and the way in which they fight the tumor.
๐ข Immunotherapy
๐ฌ How it works
It does not act directly on tumor cells, but stimulates the immune system to recognize and destroy them.
In melanoma, immune checkpoint inhibitors are mainly used:
- Nivolumab
- Pembrolizumab
- Ipilimumab
These drugs “take the brakes off” T lymphocytes, allowing them to attack the tumor.
โ Advantages
- It can give very long-lasting answers
- Some patients achieve long-term remissions
- It works independently of the BRAF mutation
โ ๏ธ Side effects
They result from excessive activation of the immune system:
- Colitis
- Thyroiditis
- Hepatitis
- Autoimmune reactions
๐ต Targeted Therapy
๐ฌ How it works
It acts directly on specific genetic alterations in tumor cells.
In melanoma it is used when the BRAF mutation is present (≈40–50%).
Most common drugs:
- Dabrafenib Trametinib
- Vemurafenib Cobimetinib
They block the tumor growth pathway (MAPK pathway).
โ Advantages
- Quick response
- Rapid reduction of metastases
- Useful in patients with symptomatic or aggressive disease
โ ๏ธ Limits
- It only works if there is a BRAF mutation
- Over time, resistance may develop
๐ Difference summarized
ImmunotherapyTargeted therapyBoosts the immune systemAttacks a specific mutationCan work in all patientsOnly if BRAF mutatedSlower responsesRapid responsesAutoimmune side effectsFever, rash, skin toxicity
๐ฏ In practice
- If the melanoma is BRAF mutated, you can choose between both (depending on the clinical case).
- If BRAF is not mutated, immunotherapy is used.
- In aggressive cases with significant symptoms → it is often preferable to start with targeted therapy due to the speed of action.
At Oncogenoma, our goal is to provide comprehensive and compassionate care, from diagnosis to recovery. In addition to excellent clinical care, we offer patient counseling, multilingual support groups, and dedicated caregivers to guide you and your family every step of the way.
Toll-free number: 800019330
Verona : www.dermatologiaverona.it www.casadicuradomussalutis.it
Skin Cancer Program
Leading expertise
Lifesaving cell therapies
This includes expert-led CAR-T cell treatments that are tailored specifically for you.
Over 50 clinical studies
Trials are available for all types of cancer and are designed to address each patient's specific situation.
Dedicated navigators for patients
Our navigators connect you to vital resources, so you can focus on your treatment.
Skin cancer requires a multidisciplinary team, including oncologists, dermatologists, surgeons, and radiation oncologists. Oncogenoma's Skin Cancer program offers these services and more for all types of skin cancer, so you can get cancer treatment that fits your lifestyle, not the other way around.
ONCOGENOME & CUTANEOUS MELANOMA
Melanoma research continues to progress.
New treatments for melanoma continue to be developed, allowing an increasing number of patients to live longer, free from signs and symptoms of the disease. However, current treatment options are not effective for everyone, and we are actively seeking to develop new, more effective melanoma therapies.
Our doctors are working to stage and characterize melanoma down to the molecular level. Identifying the genetic alterations that cause different types of melanoma will help us identify patients whose disease might respond better to more personalized therapies.
Melanoma and immunotherapy
Our work on melanoma focuses on harnessing the immune system to treat the disease. We are testing the possibility of enhancing a patient's own immune cells that attack melanoma, called tumor-infiltrating lymphocytes (TILs), to more effectively target the tumor. Other clinical trials include research on immune checkpoint inhibitors and experimental immunostimulatory therapies for people with melanoma.
Oncology Center Services
Regardless of the type of cancer, you'll receive comprehensive care, including medications, surgery, and radiation therapy if necessary. All our patients can also take advantage of our support services, such as patient counseling, nutritional services, and more.