Clinical stage at diagnosis could affect melanoma survival
The treatment of melanoma has experienced dramatic change in the last five years. Prior to 2011, there were very few standard of care options for the disease and overall survival was pretty poor, according to Melissa Wilson, M.D., Ph.D., assistant professor of medicine at the NYU Langone Medical Center.
Dacarbazine, a chemotherapy medication, and an immunotherapy called IL-2 were the only standard of care options, but IL-2 was extremely toxic and only about 3% of patients responded to treatment, she says. Other chemotherapy options were being used, too, and some patients were being enrolled in clinical trials to attempt to extend life, but none of the trials had an overall survival benefit – even when the tumors shrank or symptoms improved.
“In 2011 and since then we’ve had a revolution of treatment options for patients that are providing overall survival benefits,” Dr. Wilson says. The immune checkpoint inhibitor, ipilimumab, a CTLA-4 inhibitor antibody, and PD-1 inhibitors have been approved as single agents and are now being used in combination. In addition, BRAF targeted inhibitors have been FDA approved.
The introduction of these new immunotherapies and targeted therapies have enhanced survival rates. Despite these recent advances, however, some patients with stage IV disease continue to have a poor prognosis, surviving less than a year on average.