New whole body treatments for advanced cutaneous cancer

This article published in 2013 reviews information from clinical studies which looked at new treatments for cutaneous melanoma.  These include drugs that aim to stimulate the body's anti-tumor immune response, such as ipilimumab (Yervoy) and tremelimumab and those that target genetic mutations in cancer cells.

Treatment of metastatic melanoma is generally palliative (supportive) and not curative. For many years, it involved chemotherapy with dacarbazine (DTIC-Dome) and more recently with tamoxifen. Developments in the understanding of melanoma have led to the characterization of molecular mechanisms that allow it to spread and progress so quickly.  These new findings have resulted in the development of new treatments which target these specific mechanisms. These new therapies aim to stimulate the patient's immune system and increase the anti-tumor response.
 

This article summarizes findings from several clinical trials which looked at new drugs for metastatic melanoma. A treatment called interleukin 2 (or IL-2) stimulates the patients’ immune system.  This drug was approved by the FDA in 1998 and has been shown to lead to cancer remissions in 5-10% of patients. Of these patients, 60% remained progression free for 7 years.

Other new treatments target CTLA4 – this is a mechanism which prevents the immune system from overreacting.  By blocking the action of CTLA4, drugs such as ipilimumab and tremelimumab increase anti-tumor immunity.  Ipilimumab has been found to increase the overall length of survival and reduce the risk of melanoma progression by 24%.  Ipilimumab has also been licenced by the FDA. This paper also discusses tremelimumab which works in the same way as ipilimumab, but has not yet been shown to improve overall patient survival compared to standard chemotherapy.

This article also looks at treatments which target genetic mutations which appear in almost 60% of melanomas and allow cancer cells to grow abnormally fast. These therapies include vemurafenib (Zelboraf) and dabrafenib.  Both of these medications have been shown to improve the length of time the patient is progression free, and vemurafenib also increased overall survival rates.
 

In conclusion, this paper discusses studies which have looked at new biological treatment techniques for metastatic melanoma, showing overall survival rates and the progression free survival time for these treatments.
 

Some of the treatments discussed in this paper have been approved by the FDA and others are still undergoing clinical trials. These medications can sometimes have more severe side effects than the standard chemotherapy treatment.
 

If you are interested in these new treatments and would like to know if they are available, ask your doctor or oncologist for more information.