Treatment options for skin cancer (melanoma): Varieties, advantages, disadvantages, and additional details
Immunotherapy, a treatment that uses substances from the body or a laboratory to stimulate and alter the immune system's function, is proving to be a promising approach for people with advanced melanoma. This innovative treatment can serve as the sole therapy or be combined with other treatments like surgery, chemotherapy, radiation therapy, targeted therapy, and vaccine therapy.
The Role of Immune Checkpoint Inhibitors
Immune checkpoint inhibitor therapy is the most common immunotherapy drug for treating melanomas. These therapies include PD-1 inhibitors (such as pembrolizumab and nivolumab), PD-L1 inhibitor (atezolizumab), and CTLA-4 inhibitor (ipilimumab). By removing or deactivating checkpoint proteins that prevent the immune system from responding to stimulation, these drugs enable the immune system to more effectively locate and destroy cancerous cells.
Combining Treatments for Optimal Results
Combining palliative radiotherapy with immune checkpoint inhibitors is a safe and effective treatment for melanoma, showing varying survival rates. For instance, the combination of RP1, a genetically engineered herpes simplex virus-based oncolytic virus, plus nivolumab has shown deep, durable systemic responses in anti-PD-1-resistant advanced melanoma patients.
New treatments, including immunotherapy with checkpoint inhibitors and targeted therapy, have helped improve the prognosis of people with advanced melanoma, with more than half of them alive after 5 years.
Managing Side Effects
While immunotherapy shows varying levels of effectiveness and adverse effects in treating advanced melanoma, it's important to note that these treatments can cause a range of side effects. Common immune-related adverse events include fatigue, skin rash, diarrhea or colitis, endocrinopathies (thyroiditis, adrenal insufficiency), and pneumonitis.
Managing these side effects involves close monitoring and immunosuppressive treatments when necessary to balance efficacy and safety. A new class of LAG-3 antibodies recently received approval from the Food and Drug Administration (FDA).
Other Immunotherapy Approaches
Oncolytic virus therapy treats tumors locally by activating the immune system and killing cancer cells. Interleukin-2 (IL-2) stimulates the immune system and enhances the body's immune response. New treatments, such as T-cell receptor-based therapies like IMA203 targeting melanoma-specific antigens, are also being developed and show promising results.
The Importance of Early Detection and Treatment
Early detection and treatment of melanoma are crucial, as it can grow and spread to other areas of the body, making it more difficult to treat. Before starting any treatment, a person must discuss the benefits and risks with their doctor and speak with a healthcare professional if they experience side effects, particularly if they are severe.
The BCG vaccine can stimulate the immune system to destroy cancerous cells in certain areas of the body, although it is not a common treatment for melanoma. It's important to note that immunotherapy functions differently than other treatments, as it uses the body's natural defense system rather than chemicals.
In summary, advanced melanoma immunotherapy involves several mechanisms—immune checkpoint blockade, oncolytic viruses, and T-cell receptor targeting—with success rates ranging generally from about 40% to over 60% depending on the therapy and patient selection. Side effects are mainly immune-related and require careful management to optimize patient outcomes.
- Immune checkpoint inhibitor therapy, a common form of immunotherapy for melanomas, utilizes drugs like pembrolizumab, nivolumab, atezolizumab, and ipilimumab, which work by deactivating checkpoint proteins, allowing the immune system to more efficiently locate and destroy cancerous cells.
- Combining palliative radiotherapy with immune checkpoint inhibitors like nivolumab has shown potential in treating melanoma, offering varied survival rates and deep, durable systemic responses in certain cases.
- New treatments, such as immunotherapy with checkpoint inhibitors and targeted therapy, have contributed to improved prognoses for people with advanced melanoma, with over half of them alive after 5 years.
- While immunotherapy holds promise in the fight against advanced melanoma, it can also cause a range of side effects, including fatigue, skin rash, diarrhea or colitis, endocrinopathies, and pneumonitis, necessitating close monitoring and immunosuppressive treatments when required to balance efficacy and safety.
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