MELANOMA: EPIDEMIOLOGY, PATHOPHYSIOLOGY, DIAGNOSIS AND THERAPEUTIC ADVANCES
Keywords:
Melanoma, Diagnosis, Epidemiology, Etiology, TreatmentAbstract
Melanoma is an aggressive form of skin cancer, the incidence of which has increased globally in recent decades, especially in fair-skinned populations. This malignant neoplasm originates from melanocytes, the cells responsible for producing melanin, and is strongly associated with sun exposure, use of tanning beds, family history and genetic predisposition. Early recognition of melanoma is essential, as patient survival is directly related to the stage of the disease at the time of diagnosis. The identification of suspicious lesions, complemented by imaging methods and biopsies, is essential for an accurate diagnosis, allowing appropriate therapeutic interventions. The pathophysiology involves a complex interaction between genetic and environmental factors. Mutations in critical genes, such as BRAF, NRAS and KIT, play a crucial role in the development of the disease. These damages promote alterations in the DNA of melanocytes, leading to uncontrolled cell proliferation and tumor formation. In addition, melanogenesis, or melanin production, is closely related to the body's response to solar damage, being an attempt to protect against harmful radiation. However, this protection may be ineffective in individuals with a genetic predisposition to developing melanoma. Advances in treatment have been significant, especially in the last two decades. Therapeutic options include surgery, immunotherapy, and targeted therapies that specifically target mutations present in tumor cells. Immunotherapies, such as PD-1 and CTLA-4 inhibitors, have shown remarkable efficacy in promoting an immune response against the tumor, while BRAF and MEK inhibitors offer new hope for patients with melanomas that harbor specific mutations. These advances reflect a paradigm shift in the management of melanoma, aiming not only at survival but also at improving the quality of life of patients, highlighting the importance of continued research and the development of new personalized therapies.
