Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Dec 2020
[Anemia and iron deficiency - treatment options in chronic kidney disease and in chronic heart failure].
Anemia and iron deficiency are highly prevalent in chronic kidney disease (CKD) and in chronic heart failure. Both may epidemiologically predict future renal and/or cardiovascular events. ⋯ Finally, HIF stabilizers are a new treatment option for anemia in chronic kidney disease, and safety studies are currently ongoing in CKD patients. Whether patients suffering from chronic heart failure might also benefit from this treatment is currently unknown.
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Dtsch. Med. Wochenschr. · Dec 2020
[What is new in the diagnosis and therapy of malignant melanoma?]
Melanoma incidence and mortality rates are increasing. The sentinel lymph node biopsy plays an important prognostic role and is pivotal for the decision to undergo an adjuvant therapy making it an important diagnostic tool. The lack of survival benefit in patients with sentinel lymph node-positive (SLN+) melanoma upon immediate complete lymphadenectomy (CLND) suggest a parallel and not stepwise development of lymph node metastasis and distant metastasis thus questioning the role of immediate CLND. ⋯ Another novelty in the therapy of malignant melanoma is the approval of the first oncolytic virus, Talimogene laherparepvec, for the treatment of unresectable stage III and IV (M1a) melanoma. Significant progress has also been made in the treatment of patients with cerebral melanoma metastasis since studies indicate that both BRAF/MEK inhibitors and the immunotherapy with CTLA4 and PD-1 inhibitors are efficient in this group of patients. With this wide range of possible systemic therapies for advanced melanoma further studies regarding therapy sequence, combinations between targeted therapies and immunotherapy as well as biomarkers for treatment response are needed to help guide physicians find the optimal therapy for patients with advanced malignant melanoma.