Immunotherapy for Melanoma
Posted July 30, 2018
Updated on May 6, 2024
Did you know skin cancer is the most common cancer in the United States? If caught early, skin cancer is one of the easier cancers to treat. However, every hour of every day one American dies from melanoma, its deadliest form.
There are various treatments for melanoma, depending on the stage at which a patient is diagnosed, including: surgery to remove the affected area, chemotherapy, radiation therapy or a relatively new treatment called immunotherapy.
Immunotherapy, in plain terms, is using the body’s immune system to fight off cancerous cells. Immunotherapy was initially approved to treat melanoma and lung cancer but now is an integral part of treatment of most cancers. By using a patient’s own immune system, doctors can now battle cancer smarter, while circumventing some of the terrible side effects patients suffer with chemotherapy. Doctors can either stimulate the immune system to work harder and smarter at attacking the cancer cells or administer certain types of man-made immune system proteins to do the same.
The FDA-approved treatment has been highly successful at treating melanoma. Statistically speaking, before immunotherapy, the survival rate for patients with stage 4 melanoma was eight to ten percent. Using the first generation of immunotherapy drugs, the rate for survival jumped to 21 percent. With the second generation of drugs, doctors are hopeful it will rise even higher. Best of all, the patients who do respond well to immunotherapy, continue to thrive for the long term.
There are a few different types of immunotherapy. The most common are:
- PD-1 inhibitors are drugs that target PD-1, a protein that normally keeps T cells from attacking other cells in the body. By blocking PD-1, the immune system gets a boost at fighting melanoma cells and can shrink tumors.
- CTLA-4 inhibitor is another drug that enhances the immune system’s defenses. However, this drug blocks CTLA-4, another T cell protein. For melanoma patients where surgery is not an option or when the melanoma has spread to other areas of the body, this drug has been shown to help people live longer.
- LAG-3 inhibitor relatlimab is a human IgG4 LAG-3-blocking antibody that restores effector function of exhausted T cells. The combination of PD1 inhibitor nivolumab in combination with relatlimab is used in treatment of metastatic melanoma.
- Targeted therapy with BRAF inhibitors is used in patients with melanoma harboring specific mutations called BRAF V600E. These are oral medications that are provided to certain patients after surgery to reduce the risk of the cancer coming back or patients with advanced disease.
- Cytokines are proteins in the body that just generally boost the immune system. The man-made versions of cytokines are sometimes used in melanoma patients, post-surgery or in conjunction with chemotherapy. Some patients and/or their caregivers can learn how to administer this treatment at home.
Compared to chemotherapy, these treatments are very well tolerated by patients. Administered in the same way, through intravenous (IV) infusions, in a comfortable setting every few weeks, these drugs do not have the same effects on the body. While there are side effects associated with immunotherapy, patients do not lose their hair or experience the amount of nausea and fatigue many chemotherapy patients do.
Serious side effects tend to happen more often with CTLA-4 treatment than with the PD-1 inhibitors. Generally speaking, these are not nearly as common as those experienced during chemotherapy. Because the immune system is in attack mode, it can become too aggressive and fight normal, healthy organs and cells. Those side effects can involve skin (rashes), endocrine (hormone-making glands) system, bowel and lungs. You should report any issues to your oncologist immediately as there may need to be an abrupt stop in the treatment to restore proper immune system defense modes.
Summa Health Cancer Institute is a leader in cancer treatments, with nationally recognized cancer centers that serve thousands of patients each year. We make the difficult journey from cancer diagnosis through treatment and survivorship as easy and seamless as possible. Our goal is to cure the cancer, if possible, while improving our patients’ quality of life. By combining the latest cancer treatment technology with personalized, compassionate, patient-centered care, we create an environment focused on whole-person healing.
For more information, call 330.375.7280 in Akron and 330.615.4126 in Barberton.
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