The Latest on Melanoma Treatments
Editor’s Note: According to the American Academy of Dermatology (AAD), melanoma is the deadliest form of skin cancer, accounting for approximately 75 percent of skin cancer deaths (1). Approximately 9,940 U.S. residents are expected to die from this disease in 2015 (2). Melanoma is highly treatable when detected early, but survival rates decline for patients whose melanoma has spread to the lymph nodes and other organs.
But targeted therapy and immunotherapy are now viable treatment options for patients with advanced melanoma – although, the AAD emphasizes, the best chance of survival is still early detection.
Here, from AAD experts – board-certified dermatologist Rhoda M. Alani, MD, FAAD, Herbert Mescon Professor and chair, department of dermatology, Boston University School of Medicine, and dermatologist-in-chief, Boston Medical Center; and Debjani Sahni, MD, assistant professor of dermatology and director, cutaneous oncology program, Boston University School of Medicine, are updates on treatments for advanced melanoma.
In recent years, researchers have developed drugs to target BRAF mutations, a type of genetic defect that occurs in more than half of melanoma cases. Alani says that these drugs have proven to be very effective in “turning off” cancer genes by blocking their reproduction and survival pathways, thus stopping further growth and shrinking tumors.
Although BRAF inhibitors are initially effective, Sahni says, melanomas inevitably develop resistance to these drugs by finding ways to get around the blocked pathway. To combat this resistance, scientists developed MEK inhibitors, another type of targeted therapy drug that blocks this pathway at a different step.
Today, BRAF inhibitors and MEK inhibitors are used in combination to provide more effective, longer-lasting treatment for advanced melanoma. And because the side effects of these drugs counteract each other, patients treated with both may experience fewer adverse reactions than those treated with either drug alone.
Targeted therapy allows doctors to provide patients with more personalized care based on their specific tumors, Alani says, according to an AAD news release. Researchers are now investigating targeted therapies for melanomas that are not triggered by BRAF mutations, as well as melanoma that occurs on places other than the skin, such as melanoma of the eye (also known as ocular melanoma or uveal melanoma). In the future, Sahni says, doctors may use a combination of three or four targeted therapy drugs to provide even more effective treatment.