Digital dermoscopy technology in precise early

melanoma detection-prognosis and new

treatment options
Jemnoschi-Hreniuc Irina-Mihaela,
Garlescu Nona,
Moraru Dan-Cristian,
Moraru Marius-Constantin,
Statescu Gabriel,
Luca Cristina,
Tecuceanu Angela,
Tamas Camelia

University of Medicine and Pharmacy „Grigore T. Popa”, Iasi

What is melanoma

Definition
A form of cancer that begins in melanocytes
(cells that make the pigment melanin). It
may begin in a mole (skin melanoma), but
can also begin in other pigmented tissues,
such as in the eye or in the intestines.

Sun Genetic Environment AWARDS CONTACT

HOBBIES
exposure factors components
 Treatment options

Surgery Immunotherapy

Chemotherapy Targeted Therapy Drugs

Radiation Therapy
 New perspectives for the treatment of
melanoma skin cancer
New drugs
The reality of affecting the
whole body

Early and defined Vectors using

surgery nanotechnology to target
the cell
Highter doses

A combination of all the above

What to watch

Ouzo effect, and then

anti-cancer drug DOX
 Why nanotechnology

Approximately 70% of patients with cutaneous melanoma have gene mutations in the key signaling pathways
(Flaherty, 2012). Targeted therapy, a crucial systemic treatment, is a novel method through using small molecule
inhibitors or antibodies to affect oncogenic sites. In melanoma, these small molecule inhibitors primarily include BRAF
inhibitors, MEK inhibitors, CKIT inhibitors, vascular endothelial growth factor inhibitors, P13K-AKT-mTOR pathway
inhibitors, cyclin-dependent kinase inhibitors, and receptor ErbB4 inhibitors (Domingues et al., 2018). Approximately
50% of metastatic melanoma lesions have mutations in the serine-threonine kinase BRAF, mostly that of valine to
glutamine in codon 600 (Davies et al., 2002). At present, the high and rapid response rates as well as good safety
profile of BRAF-targeted agents offer an unprecedented opportunity for a neoadjuvant approach in melanoma
treatment.

Siu et al. (2014) designed non-covalently functionalized nanotubes as a delivery vector for small interfering RNA
(siRNA) targeting BRAF gene silencing. The uptake of BRAF siRNA in melanoma tissue has been observed, resulting in
regressing the tumor growth in mouse melanoma models. Similarly, Tran et al. (2008) used a unique nano-liposomal
ultrasound to deliver siRNA specifically targeting V600EB-Raf and Akt3 into cutaneous melanoma, suppressing the
tumor development and preventing the metastasis.
Nanomedicine with multifunctional design greatly increases the
sensitivity of cancerous cells to drugs, reactive oxygen species (ROS),
X-ray radiation, and heat, thus improving the therapeutic effects of
several treatments in a synergistic manner.
Synergistic
Radio/Photothermal/Photodyna
mic-Therapy

Synergistic
Immuno/Photodynamic-
Therapy

Synergistic
Chemo/Immuno/Photothermal-
Therapy

Synergistic
Sono/Chemo/Photothermal-
Therapy
Background and Aim

 Melanoma is the most serious form of

skin cancer causing most of the skin
cancer-related deaths.
The incidence of melanoma has risen so
dramatically over past few years that no
other solid or blood malignancy comes
close to it in terms of increased
incidence.
The main issue is low treatment
response in conventional therapies.
The aim is a low total body impact with
high melanoma cells targeted treatment.
 Material and methods

32 patients in 2 years (18 male and 14 female),

age 24-63,
multiple nevi all over the body,
new dermatoscopy scanning for the bigger ones,
history of sun exposure, dust and toxic agents,
2019-2021
 Key words

melanoma, treatment, options, chemotherapy, perspectives

 Materials and methods:

Our patients came for a routine check of some naevi and found
out that some of them are atipital.
The certain diagnosis was taken after large excision according
with Breslow scale and then anatomopathology.
All 32 patients had a great postop evolution, benefit from
oncology check and
-13 had chemotherapy,
-12 had immunotherapy and
-7 had both chemotherapy and radiotherapy in short sessions.
 Oncology follow up

13 had chemotherapy

12 had only immunotherapy

7 had chemotherapy and radiotherapy

11 among them had gene mutations and they were good candidates for new nano-drugs

They entered in an oncologic drug trial and after 2 years follow up their tumor was still gone,
the overall impact was good, the quality of life was improoved
 Results:

DDFU has proven to be effective and: 80% overall improovement

-new cases discovered early
-new treatment options 0% side effects
-longer life expectancy
-better treatment compliance
-less side effects
10% variety of mutations
and lack of response
 Conclusion

Long-term follow-up is required in these high-risk populations to allow the detection of

slow-growing melanomas.

Telemedicine already is, and will be, an important link between clinicians and experts.

Finally, although the benefits of dermoscopy in the early diagnosis of melanoma have
been confirmed in many studies, the public health impact of dermoscopy requires further
study and more education in mases, because early diagnosis and treatmeant save lives.

Early discovery saved lifes, and improove it with 80%

DDFU is painless, easy

downside: needs and expert to do it

 After conclusion
Early diagnosis with DDFU is suitable for nanotechnology
In addition to all these therapeutic advantages, nanoparticles also present some drawbacks, such as the
agnostic cytotoxicity and biocompatibility.

Additionally, the safety and long-term effects of nanoparticles in melanoma therapy are unknown. For example,
the aggregation of large nanoparticles in the endoplasmic reticulum, inducing autoimmunity.

Thus, different nanoparticles exhibit distinct collateral effects, and if without a proper engineering or
functionalization, they could prove fatal (Jabir et al., 2012).

Most importantly, future direction to melanoma theranostic will first rely on NIR imaging-guided
detection and excision with clear tumor margins at three-dimensional angles.

The second step will apply synergistic combination therapy based on an efficient nanomedicine strategy.

To achieve this two-step theranostic, nanoparticles combined with both targeting imaging and multimodal
therapy ability are highly needed in both lab-scale small animal models and clinical settings.

In addition, the current instruments for NIR fluorophore detection mainly focus on the NIR-I window, and
it is important to further move the NIR imaging-guided surgery to the NIR-II window with much improved
imaging contrast and penetration depth (Ding et al., 2019; Zhang et al., 2019; Li et al., 2020; Wang et al.,
2020; Xu et al., 2020).
THANK YOU
Stay safe
Protect from the sun
Inspect your body
Do not neglect regular visits to specialist