Melanoma and Immunotherapy

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The latest statistics on melanoma are disheartening: in the United States, it is the rarest form of skin cancer, accounting for only 2% of all cases and yet is responsible for 75% of all skin cancer deaths every year. These sobering facts only reinforce the need for education about prevention (with daily broad-spectrum sunscreen use), awareness (with regular self-examinations of moles on the body) and the desperate need for effective treatment of this deadly and aggressive disease.

In recent years, the development of immunotherapy has become a ray of hope for those with melanoma. This disease presents itself initially as darker spots on the skin before spreading within the body to other organs. Cancerous tumors have the ability to gather cells around them to protect themselves from the immune system. Using drugs called checkpoint inhibitors, immunotherapy essentially shuts down the tumors’ ability to hide. This allows T-cells, (a type of white blood cell that searches out cellular abnormalities and infections) to identify and attack cancer cells the way they would a virus, literally unleashing them.

A 2015 study using a combination of two checkpoint inhibitors to treat 314 patients with advanced melanoma resulted in significant tumor shrinkage for 57.6% of the patients and tumor stability for more than 11 months afterwards. With these impressive outcomes, immunotherapy is being eyed as the first treatment for certain types of cancer as opposed to a final effort after more traditional radiation and chemotherapy. Former US president Jimmy Carter was successfully treated with immunotherapy recently for metastatic melanoma, an aggressive form of the skin cancer that had spread to his liver and brain.

Despite the promising potential of immunotherapy, it is not without its drawbacks: side effects on the body can be severe and can damage many of the major organs, and with a hefty $150,000 price tag per year for a course of treatment, it may still be out of reach for many who need it.

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