fbpx
Your Guide To Doctors, Health Information, and Better Health!
Your Health Magazine Logo
The following article was published in Your Health Magazine. Our mission is to empower people to live healthier.
Isabella Martire, MD, Board Certified In Oncology
Targeted Therapies Stage IV Melanoma
Isabella C. Martire, MD, AC
. https://www.isabellamartire-md.com/

Targeted Therapies Stage IV Melanoma

Until recently very few therapies were available for advanced melanoma, and the average survival was approximately nine months. The chemotherapeutic agent dacarbazine had approximately 15% response rate. Interleukin 2 had less than 10% response rate with 5% durable responses, but very high toxicities requiring ventilator and pressor support.

In recent years a better understanding of the biology of melanoma led to the development of new targeted agents with improved survival and an improved toxicity profile.

Approximately a decade ago researchers noted that approximately 50% of melanomas had a mutation of the serine/threonine kinase gene BRAF, which led to the development of the BRAF inhibitors vemurafenib and dabrafenib.

FDA approved in 2011, Vemurafenib had 80% response rate and increased the one year survival to 50% and two year survival to 40%. With vemurafenib, 6% of patients had complete response. The most common side effects are rash, joint pain, fatigue, nausea and hair loss.

Dabrafenib is another BRAF inhibitor with a response rate of approximately 60% and improvement in overall survival as well. DVT, cardiomyopathy, hyperglycemia are some of the side effects. Both BRAF inhibitors are oral drugs.

Approximately 10-20% of melanomas harbor the kit mutations. Imatinib is a multikinase inhibitor that has some efficacy in this type mutation with a response rate of approximately 30%.

Ipilimumab is a human monoclonal antibody that targets T-lymphocyte antigen 4 and by doing so continually activates T cells against the melanoma cells. The response rate to the monoclonal antibody is low approximately 15% but in 20% of cases durable up to 4 years. Ipilimumab is currently being tested in combination with other agents. Colitis, hepatitis, inflammation of the skin and nerves are potential side effects.

Currently nivolumab, a human PD-1 antibody, is also being investigated, as a new target to fight melanoma. Progress continues to be made to fight this very difficult to treat disease.

www.yourhealthmagazine.net
MD (301) 805-6805 | VA (703) 288-3130