B. Traitements séquentiels
V. Conclusion
Les thérapies ciblées chez les patients très âgés atteints de mélanome représentent donc un challenge nouveau. Cette étude monocentrique et rétrospective ne nous permet pas de tirer des conclusions certaines mais témoigne d’une pratique en “vie réelle” et reflète ainsi les interrogations du quotidien. Elle laisse entrevoir une bonne tolérance globale avec cependant un profil de tolérance un peu différent de la population générale, ainsi qu’un impact plus important des effets indésirables sur la qualité de vie et l’observance du traitement. Une adaptation de la posologie initiale selon la concentration résiduelle des traitements, et non uniquement lors de la survenue d’effets indésirables, semble être une piste intéressante pour améliorer ces deux derniers points.
Une prise en charge globale doit être proposée à cette population très âgée, impliquant oncodermatologues, oncogériatres, pharmaciens et infirmières afin de mieux identifier et de mieux accompagner les patients très pouvant tirer un bénéfice de ces thérapies ciblées.
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