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Medications for Melanoma

The primary treatment for melanoma is surgical removal of the tumor. Although requiring further clinical trials, in some cases, immunotherapy or targeted therapy may be used in the treatment of advanced stages of melanoma.
Many combination therapies are currently in trials. Advanced melanoma patients should be considered for enrollment in a trial for their own benefit as well as for the advancement of melanoma treatment. Thus far, no single investigative approach stands out as highly effective; however, they all hold promise with rare patients showing durable responses. Most treatment protocols are evaluating combinations of adjuvant therapies, hoping to achieve a synergistic effect. Ongoing research into the biology of melanoma continues to suggest new drug targets that will block tumor progression or enhance host response.

Immunotherapy

Immunotherapy involves using medications or substances made by the body to increase or restore the body's natural defenses against cancer. It is also called biological response modifier (BRM) therapy . Examples include interferon, interleukin-2, ipilimumab, and melanoma vaccines.
Side effects include chills, fever, aches, depression, and fatigue. At times, these can be a significant barrier to successful treatment.

Targeted Therapy

About half of melanomas have a gene mutation known as BRAF. This gene causes the body to make proteins that accelerate the growth of cancer cells. Targeted therapy uses medications to seek out the cells with the BRAF mutation and destroy them. Targeted therapy medications include:
  • Vemurafenib (Zelboraf)
  • Dabrafenib
  • Trametinib
Although these medications are not a cure for advanced melanoma, it can increase a patient's survival rate. The most common side effects are joint pain, fatigue, hair loss, rash, itching, sensitivity to the sun, and nausea.

Promising Therapies

Researchers are currently studying new drugs and therapies to treat melanoma. Therapies being studied include:
  • Melanoma vaccines—researchers are studying vaccines that may help the body fight melanoma; currently only available in clinical trials
  • Tumor infiltrating lymphocytes (TILs)—special cells that show promise in shrinking tumors are being studied
  • Genetically altered T-cells—cells in the body that when altered may be able to shrink tumor cells
  • Gene therapy—researchers are studying ways to alter genes so that they fight melanoma more effectively

References

Bedikian AY, Johnson MM, et al. Systemic therapy for unresectable metastatic melanoma: impact of biochemotherapy on long-term survival. J Immunotoxicol . 2008 Apr;5(2):201-7.

Eggermont AM, Robert C. New drugs in melanoma: It's a whole new world. Eur J Cancer . 2011 Sep;47(14):2150-2157.

Hancock BW, Wheatley K, et al. Adjuvant interferon in high-risk melanoma: the AIM HIGH Study—United Kingdom Coordinating Committee on Cancer Research randomized study of adjuvant low-dose extended-duration interferon Alfa-2a in high-risk resected malignant melanoma. J Clin Oncol . 2004;22(1):11-4;7-10.

Lens M. The role of vaccine therapy in the treatment of melanoma. Expert Opin Biol Ther . 2008 Mar;8(3):315-23. Review.

Lipson EJ, Drake CG. Ipilimumab: an anti-CTLA-4 antibody for metastatic melanoma. Clin Cancer Res . 2011 Sep 7.

Melanoma. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated April 3, 2013. Accessed April 10, 2013.

Melanoma skin cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003120-pdf.pdf . Updated January 17, 2013. Accessed April 10, 2013.

Melanoma treatment. Treatment options by stage. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/melanoma/Patient/page5 . Updated March 29, 2013. Accessed April 10, 2013.

Stein JA, Brownell I. Treatment approaches for advanced cutaneous melanoma. J Drugs Dermatol . 2008 Feb;7(2):175-9.

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