Categorized | Of Interest

Finding new ways to fight melanoma

Source: Health and Wellness, by KAREN WEINTRAUB, May 2014

The most recent (and promising) melanoma therapies:

Targeted therapies

These drugs work very well for a subset of advanced melanoma patients whose tumors have certain gene mutations. For them, the therapies are very effective — but only until the tumor develops new mutations.

  • Vemurafenib Approved in 2011, this targeted therapy inhibits the BRAF gene.
  • Dabrafenib Approved in 2013, this drug also inhibits BRAF.
  • Trametinib Approved in 2013, this inhibits a related gene called MEK. In 2014, the federal government approved dabrafenib and trametinib to be used as a combination therapy. This combination has been shown to help three-quarters of patients, adding nearly one year of life.

Immune therapies

These stimulate the patient’s immune system to fight off cancer. So far they have only helped a minority of patients, but newer drugs are expected to help more people, and also show promise well beyond melanoma. Because the person’s body learns to fight off the tumor, these therapies have the potential to keep the cancer in check for years, or decades.

  • Interleukin-2 This was the first immune therapy to show dramatic results in melanoma, but only for about 7 percent of patients. Approved in 1998, many of the patients who initially did well on this drug are still alive.
  • Yervoy Approved in 2011, this drug, also called ipilimumab, releases a brake that cancer puts on the body’s immune system. It works very well in 10 to 20 percent of patients, extending lives for years.
  • Nivolumab and MK3475 Two versions of similar drugs, one by Bristol-Myers Squibb and the second by Merck, are expected to be approved by the Food and Drug Administration as soon as this summer. Recent studies show they can keep more than 40 percent of patients alive for at least three years. Combining Yervoy and nivolumab may help even more patients than the single drugs alone, studies suggest.
  • PDL-1 antibodies These drugs act on similar parts of the immune system as nivolumab and MK3475 but may be even more effective with fewer side effects. Several of these drugs are in research trials and could come up for approval as soon as next year.

Cell transfer therapies

In this approach, doctors take immune cells from the patient that appear to be effective at fighting the cancer. By amplifying these cells in a lab and putting greater numbers back into the patient, researchers hope to give the immune system enough boost to keep the cancer in check. It is a complicated process and likely to be costly, but small studies have shown it has great promise against a vast range of cancers.

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