How would you approach a patient with clinical T3N1 anorectal malignant melanoma referred by a surgeon for neoadjuvant therapy?

Topics: Radiation Oncology • Gastrointestinal Cancers • Melanoma/Skin Cancer • Medical Oncology • Colorectal Cancer

Is there a potential role for concurrent radiation therapy? What if the tumor is BRAF mutated?

Answer from: Medical Oncologist at Academic Institution

Anorectal malignant melanoma is quite rare and only <1 percent of all anorectal cancer are mucosal melanoma (Cagir et al., PMID 10496563) Patients with newly diagnosed anorectal malignant melanoma should undergo HIV screening since HIV infection is considered to be one of the main risk facto...

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Medical Oncologist at NYU Langone Medical Center
Thank you for the insights, references, and recomm...

Answer from: Radiation Oncologist at Community Practice

Ok to tag on to this case, how about a deep pT4a cN0M0 BRAF WT low rectal mucosal melanoma s/p local excision with positive peripheral and deep margins, the only way to get R0 is with APR. Would you recommend SC-RT (6 Gy x 5 fx) followed by ipi/nivo followed by APR? Or APR followed by ipi/nivo (om...

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Radiation Oncologist at Memorial Sloan Kettering Cancer Center
I agree with some of the comments above. The risk...

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