MANAGEMENT OF THE ELDERLY PATIENT WITH MELANOMA E. Caputo, S. Travali Vol.3 (2018), issue 3, pag. 21-29
The incidence of cutaneous melanoma continues to rise with age. Clinically, aged melanoma patients show a poorer prognosis than young. Older men present a higher risk to develop melanoma compared to women. It has been demonstrated that the biological behavior of melanoma is different between old and young patients; old patients more frequently present a higher Breslow’s thickness, a higher occurrence of histological ulcerative lesions, higher proliferative index and a worse disease-speci c survival. Although recent studies seem to correlate the immunosenescence and the aged microenvironment to this unfavorable behavior in the elderly, it remains still poorly understood.
In this review we discuss the melanoma properties in elderly, the current therapies for melanoma treatment and their use to treat old melanoma patients. We summarize the clinical experience with immunotherapeutic and target- based drugs for elderly melanoma patients. We also discuss the necessity of a future personalized approach for the treatment of old melanoma patients, by a Comprehensive Geriatric Assessment (CGA) in a multidisciplinary context.