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The Sky is the Limit: Advances in the Management and Treatment of Metastatic Melanoma

In this post, we take a closer look at recent advances on the treatment of metastatic melanoma through  BRAF inhibitors, in particular.  In brief, the BRAF genetic mutation that occurs in cancer cells is deadly in that it triggers cancer growth.  About half of all melanoma cases are reported to have the BRAF mutation.

Recently, the Cancer Network (CN) interviewed Dr. Jeffrey Sosman regarding the progress of immunotherapy for treating metastatic melanoma.  Dr. Sosman is a Medical Oncologist and the Director of the Melanoma and Tumor Immunotherapy Program at Vanderbilt-Ingram Cancer Center in Nashville, Tennessee.

 

In this post, we highlight the most significant points Dr. Sosman makes for Derm practitioners, particularly as we look toward the future for the treatment of advanced stages of melanoma in the realm of immunotherapy.

In their interview CN begins by discussing the immunotherapy antibody, anti-PD1 which shows high activity for metastatic melanoma. Dr. Sosman highlights the latest progress shown by ipilimumab (Yervov–approved 1 year ago), the anti-CTLA-4 or anti-PD1, drug that “breaks tolerance.”  In other words, it causes the immune system to stop tolerating the cancer.  

In the future, as researchers discover what markers or triggers induce this “tolerance,” a drug such as ipilimumab may be the go-to approach in encouraging the antitumor effects to attack the tumor itself.

CN moves on to discussing targeted therapies such as vemurafenib (Zelboraf–now approved), as well as dabrafenib and trametinib (in stage 3 trials), and asks Dr. Sosman to give his take on their differences and utilization of each.

 

Check our recent Dermcast posts on vemurafenib both here and here.

 

Dr. Sosman explains that both vemurafenib and the dabrafenib are BRAF inhibitors that have similar antitumor effects.  Most patients have tumor shrinkage, and over 85% of patients get actual shrinkage and the median duration of shrinkage is approximately 6 to 7 months. However, the side effects of each are different. Vemurafenib causes significant photosensitivity and sunburn. With dabrafenib there is more risk for fevers and chills, and less concern for sunburns. 

We can only hope for an increase of trails combining such therapies as trials of ipilimumab and vemurafenib.   It is apparant that there is much to be learned in the cross-over between immunotherapies and targeted therapies.  

As Derm practitioners, we’re thrilled for the way in which current  research is bringing more hope for survival to advanced stage melanoma patients.

 

Read More concerning BRAF-inhibitors on Dermcast Here

 

[image by Satoru Kikuchi]

Sources: Cancer Network