New Melanoma Treatments

By Sheryl Clark MD
August 28, 2011
Category: Melanoma
Tags: Skin Cancer  

Many patients have asked about the new treatments for advanced melanoma that have been covered in the media of late.  In March, Bristol-Myers Squibb's Yervoy (ipilimumab), a slow-acting immunotherapy for patients with advanced melanoma, was approved by the FDA.  On August 17, Roche Genentech's Zelboraf (vemurafenib), which targets a BRAF V600E mutation which is found in 40 to 60 per cent of patients' melanomas, also received FDA approval.  While both shown promise in their ability to prolong the lives of patients with metastatic melanoma, neither is a cure for these patients.  Although previous therapies have shown little benefit, the good news is that both of these treatments have been able to give affected patients a significant remission from their disease, but the bad news is that no long-lasting remissions or cure from melanoma can be expected.

Also, only about half of patients tested responded to Zelboraf.  Since BRAF mutations are more common in yougner patients who have melanoma, younger patients are more likely to respond.

Since the two act via different but complementary mechanisms, they may work better together, and a Phase III trial is about to start using them in combination.  We are hoping better results will be seen.  In the meantime, since Yervoy is slow to act wheras quick remissions have been seen with Zelboraf, Yervoy will probably be used in patients with metatastic disease that is not rapidly advancing, saving Zelboraf for later more advanced disease, and Zelboraf may be used for patients with rapidly advancing disease.  There may still be a role for the more familiar treatment with Interleukin-2 (IL-2), since the side effects with Yervoy can be severe.  The role of the current therapies of interferon and DTIC, as well as IL-2,  may be uncertain without comparative studies, but undoubtably there will be a role for each of these agents for some patient.

The best cure is PREVENTION.  Come and learn about what your specific risk factors might be and what you can do to minimize those risks.

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