For years, there was little, if anything, doctors could offer for advanced or spreading melanoma, the potentially fatal form of skin cancer.
But that was then.
“The landscape has totally changed and for the first time we have been able to essentially cure metastatic disease. What was once fatal now has real hope,” says Mona Mofid, MD, FAAD, Medical Director, American Melanoma Foundation and a dermatologist in San Diego, Calif.
Take former U.S. President Jimmy Carter, for example, she says. Diagnosed with metastatic melanoma in his ninth decade, he is now cancer-free. “I personally have four patients who had metastatic disease in the brain or lung whose melanoma is now undetectable,” she says. “There is so much research going on into repairing gene abnormalities that a melanoma cure is attainable!”
Considering that one person currently dies in this country every hour of melanoma, “the magnitude of future lives saved is magnificent,” she says.
Still, when doctors spot melanoma early, removing it surgically produces a cure rate approaching 100% — which means that nothing will take the place of prevention and early detection – ever.
Sea Change in Advanced Melanoma Treatment
That said, the biggest game-changers in recent years can be divided into two categories –immunotherapy and targeted therapies. Immunotherapy treatments prime the immune system to fight the cancer. Targeted therapies take aim at common genetic mutations found in a subset of individuals with melanoma such as the BRAF gene. A mutated copy of BRAF called V600E is found in about half of all melanoma patients. It produces an abnormal version of a protein that leads to out-of-control growth of melanocytes, the pigment cells where melanomas arise.
New immunotherapy meds for melanoma approved by the FDA include:
- Ipilimumab (Yervoy)
- Nivolumab (Opdivo)
- Peg interferon alfa-2b (Sylatron)
- Pembrolizumab (Keytruda)
- Talimogene laherparepvec (Imlygic, T-VEC)
- Ipilimumab® + Nivolumab® combination
Targeted therapies recently approved:
- Cobimetinib (Cotellic) in combination with vemurafenib
- Dabrafenib (Tafinlar)
- Trametinib (Mekinist)
- Vemurafenib (Zelboraf)
- Dabrafenib (Tafinlar®) + Trametinib (Mekinist®)
The high costs of these drugs are a major concern, both for doctors and patients.
“The new drugs to fight melanoma are promising indeed. It looks like we are getting better at treating advanced melanoma. However, the overall survival of advanced melanoma remains poor,” says Gary Goldenberg, MD, a Assistant Clinical Professor, Dermatology at Mount Sinai School of Medicine in New York.
“That’s why prevention, early detection and surgical removal are still the best treatment. Be sun smart and see your dermatologist regularly. It may save your life,” says Goldenberg.
To find a board certified dermatologist near you, visit AAD.ORG