*FDA HAS APPROVED LENALINOMIDE FOR REFRACTORY MANTLE CELL LUMPHOMA
"Out of 133 patients who were evaluable for efficacy: 26% had an overall response; 7% achieved a complete response or an unconfirmed complete response; and 19% achieved a partial response. Median duration of response for the patients who achieved a complete, an unconfirmed complete, or a partial response was 16.6 months." PER ONCOLOGY TIME.

*AS THE INCIDENCE OF MELANOMA IS INCREASING, IT IS WELCOME NEWS THAT THERE IS PROGRESS IN THE MANAGEMENT OF THIS DISEASE, AND THE INTRODUCTION OF IPILIMUMAB AND VEMURAFENIB HAVE CHANGED NCCN GUIDELINES.
YET THE REPORTED 20 YEAR SURVIVAL IS STILL REPORTED AS

STAGE I        90%      WITH 10% OF PEOPLE DYING WITH THIS DISEASE
STAGE II        50%      WITH HALF OF THESE PATIENTS DYING OF MELANOMA
STAGE III       40%       WITH 60% DYING OF THE DISEASE
STAGE IV       5-10%    WITH 90-95 % DYING.

FOR A WHILE THERE, THERE WAS NO CHANGE OF SURVIVAL IN STAGE IV UNTIL THE ARRIVAL OF IPILIMUMAB, A T CELL ACTIVITY MODULATOR.
AND FOR THOSE BRAF POSITIVE, VEMURAFENIB IS AN OPTION.  REISTANCE TO BRAF CAN BE EXPECTED IF GENES DOWN STREAM ARE OVEREXPRESS. THIS IS WHERE MEK IS LOCATED, AND ADDING ANTI MEK (TRAMETINIB) TO ANTI-BRAF (DABRAFENIB) HAS BEEN SHOWN TO INCREASE RESPONSE RATE.   NOTABLY THE COMBINATION HAS LESS SKIN TOXICITY. BUT GET READY TO FIGHT PYREXIA IF YOU GO THIS WAY!

CONSIDER SENTINEL NODE DISSECTION IN PATIENT WHO'S LESION THICKNESS IS GREATER THAN 0.75mm.