Melanoma is treated with surgery, radiation or medications (systemic therapy) depending on the type of melanoma and whether the cancer has spread or remains localized to the skin. Several types of medications or systemic therapies are prescribed for locally advanced or metastatic melanoma including targeted therapy and immunotherapy.
What is Immunotherapy?
Immunotherapy is a type of therapy that stimulates the immune system to respond to foreign cells in the body such as cancer. Previously, medications such as interferon and interleukin-2 were used to make the immune system more active, but patients often had severe fatigue, fever, chills, and other symptoms associated with an overactive immune system. In recent years, specific drugs targeting and activating “soldiers” of the immune system, T-Cells, have been developed with more success against melanoma and with fewer side effects. Immunotherapies have become the standard of care treatment for certain cases of melanoma.
How does Immunotherapy Work?
Immunotherapy works by using checkpoints, which are proteins on cells inside your immune system that need to be turned on or off in order to start an immune response. Cancer itself spreads because it camouflages its cells to look like normal cells, when they are not. Immunotherapy drugs are able to target these checkpoint proteins to then help restore the immune response against harmful melanoma cells.
Treatment with Immunotherapy
Targeted immunotherapy drugs for melanoma may include:
- Checkpoint inhibitors
- PD-1 inhibitors - drugs that target the PD-1 protein on immune system T-Cells that normally help keep these cells from attacking other cells in the body. By blocking PD-1, these drugs boost the immune system's response against melanoma cells and can often shrink tumors and help people live longer.
- CTLA-4 inhibitor - drugs that boost the immune system's response and blocks a protein on T-Cells that normally helps keep them in check, called CTLA-4. This drug class has also been shown to shrink tumors and help people live longer.
- Oncolytic virus therapy - an altered, inactive virus made in a lab with the purpose of stimulating the immune system to kill cancer cells.
All of the above immunotherapy treatments are FDA-approved and are commonly used as melanoma treatment options. Immunotherapy drugs may be used alone or in specific combination with other immunotherapy drugs. A melanoma treatment plan could also consist of a combination of immunotherapy and surgery, radiation, chemotherapy or other treatment options.