In a nutshell
This article reviewed treatment options for patients with advanced melanoma.
Treatment for melanoma depends on several factors, including the disease stage. Advanced melanoma is diagnosed when cancer can be detected outside of the original tumor. This makes treatment difficult. Currently, there are several options to treat patients with advanced melanoma. These target cancer cells using different strategies.
Methods & findings
Cancer cells can switch off T-cells (immune cells) using specific molecules. Targeted therapy interferes with this process to help the body's immune system attack cancer cells. In one study, 58% of patients responded to ipilimumab (Yervoy) and nivolumab (Opdivo) combined. 62% of patients responded to ipilimumab and pembrolizumab (Keytruda). Other targeted therapies remain under development. These may help patients who do not respond to currently available treatments.
Ipilimumab is being used in combination with a treatment called T-VEC (Imlygic), which directs immune responses to tumors. One study showed that T-VEC improved patient responses to ipilimumab from 18% to 39%. Ongoing trials are examining the combination of T-VEC with other drugs.
Another strategy being developed is to activate immune cells while preventing cancer cells from switching them off. An activator called TLR9 activates T cells to help attack cancer cells. Clinical trials of TLR9 have shown promise.
Many patients with melanoma have specific mutations that drive cancer growth. These mutations include BRAF and MEK. Targeted therapy uses these mutations to locate and kill cancer cells. Encorafenib (Braftovi) targets BRAF, and binimetinib (Mektovi) targets MEK. Together, these agents have improved the survival of patients to 33.6 months. However, these treatments may not be suitable for all patients.
Another treatment strategy involves removing healthy immune cells from patients, activating them to attack cancer cells, and introducing them back to the patient. This treatment is called immune cell vaccination. Although this approach shows a lot of promise, it can be expensive. The safety and effectiveness of this treatment remain under investigation.
The bottom line
This article reviewed treatment options for patients with advanced melanoma. More research is needed to further improve outcomes for these patients.
Talk to your doctor about participating in clinical trials.
Published By :
Current oncology reports
Nov 06, 2019