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 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.
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:
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.
Researchers are currently studying new drugs and therapies to treat melanoma. Therapies being studied include:
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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.
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Last reviewed March 2015 by Mohei Abouzied, MD, FACP
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