Immunotherapy and Melanoma
Immunotherapy gets the immune system to recognize and attack cancer cells. Immunotherapy is a good treatment option for many people with melanoma.
Immunotherapy works well for some patinets, but it doesn't work in everyone. Researchers are trying to learn why some tumors respond and others do not.
Immunotherapy for Stage 3 (III) Melanoma
People with Stage III melanoma often have surgery to remove the melanoma. Lymph nodes near the cancer might also be removed to look for cancer cells. Your doctors will use the results to decide what treatment options are best for you. Sometimes, many lymph nodes near the tumor are removed (called a "lymph node dissection"). Other times, only one or a few lymph nodes are removed (called "sentinel lymph nodes"). In some cases, the lymph nodes do not need to be removed.
After surgery, your doctor may recommend immunotherapy to reduce the risk of your cancer coming back.
Sometimes, the surgeon cannot remove all of the cancer. This type of cancer is called "unresectable." These cancers are treatmed more like Stage 4 (IV) melanoma.
Immunotherapy for Stage 4 (IV) Melanoma
Immunotherapy may be the first treatment for Stage 4 (IV) melanoma. Some patients are treated with approved immuntherapy drugs. Others are treated with immunotherapy drugs being studied in clinical trials.
The most commonly used immunotherapy treatments for melanoma are:
- Keytruda© (pembrolizumab): This drug gets the immune system to kill cancer cells by blocking a cell checkpoint called PD-1. This helps “release a brake” on the immune system and can stimulate the immune system to fight the cancer. It is currently approved to treat unresectable stage 3 (III) and stage 4 (IV) melanoma. It is given intravenously (into a vein).
- Opdivo© (nivolumab): This drug also gets the immune system to kill cancer cells by blocking PD-1. It is used to treat stage 3 (III) and stage 4 (IV) melanoma. It is given intravenously (into a vein).
- Yervoy© (ipilimumab): This drug gets the immune system to kill cancer cells by blocking a protein called CTLA-4, which releases another “brake” on the immune system. It is mainly used to treat stage 4 (IV) melanoma. It is given intravenously (into a vein).
- Opdivo© (nivolumab) and Yervoy© (ipilimumab): The combination is used to treat patients with unresectable stage 3 (III) and stage 4 (IV) melanoma. Opdivo blocks the PD-1 checkpoint. Yervoy blocks CTLA-4. Both are given intravenously (into a vein).
- Imlygic© (talimogene laherparepvec): This drug is injected into a tumor. It contains a modified virus that attacks melanoma cells and stimulates the immune system. It is used in patients whose cancer comes back after surgery, most often if the melanoma cells are seen or felt on the skin.
Immunotherapy Side Effects
Immunotherapies boost the body’s own defense system. This stimulation of the immune system can cause side effects as the body’s immune system can become active against other parts of the body. The side effects they cause do not usually last long and are often managed easily -- especially if they are caught early. However, sometimes they can be severe or life-threatening. It is important to contact your doctors if you are taking an immunotherapy and develop a new side effect. If your symptoms are severe, you may be required to go to an emergency room. It is important that you tell the ER staff that you have cancer and are taking an immunotherapy.
You can read more about immunotherapy side effects or watch a video about side effects in the Immunotherapy Side Effects section of our website.
More videos and booklets about immunotherapy are available in this section of our website.