New Treatments for Advanced Melanoma

By

Chris Iliades, MD

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Advanced melanoma is melanoma that has spread to your lymph nodes or other parts of your body. This makes it harder to treat. However, two new types of treatment may work better than older approaches like surgery, chemotherapy and radiation.



Immunotherapy

Immunotherapy is a treatment that helps your immune system attack melanoma cancer cells. Doctors are already using some immunotherapy drugs. Others are being tested in clinical trials.

Leta talks about her journey with advanced melanoma, from discovery to diagnosis to treatment with immunotherapy.

2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

  • Ipilimumab (Yervoy) is an immunotherapy drug that blocks CTLA-4, a protein that melanoma cancer cells use to survive. Blocking CTLA-4 may allow your immune system to do a better job of finding and attacking melanoma cells. Ipilimumab is an intravenous drug. Doctors will put it directly into your veins. You may be a candidate for this treatment after surgery or if surgery cannot remove your melanoma.

  • Pembrolizumab (Keytruda) and nivolumab (Opdivo) are intravenous drugs that block a different protein, called PD-1 or PD-L1. These drugs also help the immune system find and attack melanoma cancer cells. Some studies show they work better than CTLA-4 blockers and have fewer side effects. Some people get nivolumab along with ipilimumab. You may be a candidate for one of these drugs after surgery or if surgery cannot remove your melanoma.

Targeted Therapy

Some melanoma cancer cells have gene changes, called mutations. New drugs can target these genes, so only the cancer cells are attacked. That can mean fewer side effects than with traditional cancer-killing drugs (chemotherapy). Targeted cancer therapies may also work better. If cells from your cancer test positive for a gene mutation, one of these treatments might be right for you.

  • Vemurafenib (Zelboraf) is an oral drug for melanoma with certain mutations in the BRAF gene. About half of all melanoma cancers are positive for a BRAF mutation. You may be eligible for this drug if your melanoma is advanced or can’t be treated with surgery. Studies show this drug prolongs survival.

  • Dabrafenib (Tafinlar) and trametinib (Mekinist) are also oral drugs for people with some types of BRAF mutations. Studies show they may work better when used together. These drugs may increase your risk of developing other types of skin cancer. But, they improve survival time for melanoma.

  • Cobimetinib (Cotellic) is a drug that blocks MEK, another protein involved in melanoma cancer growth. Studies show that combining this drug with vemurafenib improves survival more than vemurafenib alone.

Clinical Trials

Researchers test new targeted therapies and immunotherapies in studies called clinical trials. These trials may use new drugs or new combinations of drugs. A vaccine for melanoma is one of the new therapies. It uses “killed” melanoma cancer cells to trigger your immune system. The vaccine may help the patient's immune system attack live melanoma cancer cells.

Entering a clinical trial can be a good way to try new treatments for advanced melanoma. Ask your doctor if you qualify to participate in a study near you.

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Medical Reviewers: Judy Mouchawar, MD, MSPH Last Review Date: Feb 26, 2016

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Treatment of Melanoma Skin Cancer by Stage. American Cancer Society. http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-treating-by-stag...
  2. Melanoma Treatment: Stage IV. Melanoma International Foundation. http://melanomainternational.org/melanoma-facts/melanoma-treatment-stage-iv/#.VsCnSfkrKM8
  3. What’s New in Research and Treatment of Melanoma Skin Cancer? American Cancer Society.  http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-new-research
  4. FDA Approves Yervoy to Reduce the Risk of Melanoma Returning After Surgery. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm469944.htm
  5. Nivolumab (Opdivo). Food and Drug Administration. http://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm436566.htm
  6. Zelboraf. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/202429s000lbl.pdf
  7. Trametinib and Dabrafenib. Food and Drug Administration.  http://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm381451.htm
  8. FDA Approves Cotellic as Part of Combination Treatment for Advanced Melanoma. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm471934.htm
  9. Nivolumab. National Cancer Institute. http://www.cancer.gov/about-cancer/treatment/drugs/nivolumab

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