Evolving Paradigms in Immuno-Oncology: Treatment Strategies and Clinical Evidence for Checkpoint Inhibition

Source: Targeted Oncolgy, December 2015

Melanoma

Melanoma is an aggressive and potentially fatal form of skin cancer that accounts for the majority (76.9%) of the 13,000 skin cancer-related deaths in the United States each year, even though it accounts for less than 2% of total skin-related cancers.2,5 It is the fifth most common cancer among men (1 in 38 lifetime risk in Caucasian men) and the seventh among women (1 in 58 lifetime risk in Caucasian women).48 The incidence of melanoma has been increasing exponentially for the past 80 years with an overall, age-adjusted incidence rate of 19.7 per 100,000 as of 2011 (95% CI, 19.5-19.9) and an estimated 74,000 cases in 2015 (up from 65,675 invasive melanoma cases reported in 2011).5,48,49 Centers for Disease Control and Prevention (CDC) data gathered from 1999 to 2011 indicate that there is an increasing incidence with age, until about the age of 70, and that Caucasians account for the vast majority of all melanoma cases in the United States.16,50 The National Cancer Institute (NCI) Surveillance, Epidemiology, and End Result (SEER) Program data from 2005 to 2011 indicates that the 5-year survival rates based on stage at diagnosis are 98.3% for localized melanoma, 63% for regional, 16.6% for distant, and 80.2% for unstaged melanoma.51 Prognosis for patients with stage IV melanoma is very poor, and the 1-year survival rate is only 25%, implicating extended survival as the primary goal of treatment whenever possible.14