Immunotherapy is a treatment option that can be used for certain types of cancer, including melanoma. Immunotherapy involves the use of medications to stimulate the immune system to effectively identify and destroy cancer cells.
Immunotherapy treatment options for melanoma
There are many different kinds of immunotherapy, which work in different ways, and several types of immunotherapy can be used for treating melanoma. In fact, there are now multiple FDA-approved treatment options for melanoma patients.
This is a newer type of immunotherapy that has shown a lot of promise for patients with advanced stages of melanoma. "Checkpoints" are proteins on immune cells that must be switched off in order for an immune system response to be maximally triggered. Sometimes, melanoma cells utilize checkpoints to evade the body’s immune system attacks. Immune checkpoint inhibitors are designed to target and block these checkpoints, thereby allowing the immune system to effectively attack the melanoma cells. These medications are usually delivered through intravenous (IV) infusion in an outpatient setting. They are used to treat melanoma after it has recurred or spread following surgery, and in some cases to prevent melanoma from recurring after surgery. Different checkpoint inhibitors differ in how frequently and for how long they are given.
Oncolytic virus therapy
Oncolytic viruses are viruses that have been engineered in a laboratory to preferentially infect cancer cells. They are usually injected directly into tumors on or close to the skin. In addition to destroying the injected melanoma cells, oncolytic viruses can attract the immune system to the tumor site, leading it to target and attack melanoma cells elsewhere in the body at uninjected sites.
This approach uses immune cells taken from a patient’s own body and grown in the laboratory that are then reinfused into the patient to attack melanoma tumors that have grown despite the use of other forms of immunotherapy. This approach is still experimental, requires the patient to have good heart and lung function, and is very labor intensive; therefore, only a few centers (including Moffitt) currently offer this approach. While still in clinical trial testing, Dr. Amod A. Sarnaik and colleagues found that the tumor-infiltrating lymphocyte (TIL) therapy, lifileucel, produced durable responses in patients with metastatic melanoma.
Side effects of immunotherapy
The use of immunotherapy is associated with side effects different than those associated with traditional chemotherapy. Most side effects are a consequence of over-stimulation of the immune system, leading the immune system to attack normal, noncancerous cells in the body. The most common immunotherapy side effects include rashes, diarrhea and inflammation of the liver or lungs. Less common side effects include damaging the functions of the endocrine system (leading to diabetes, hypothyroidism, fatigue and other conditions), the neurologic system (causing weakness, numbness, headaches, confusion and others) and the cardiovascular system (resulting in swelling, lightheadedness, heart failure and others). Most side effects gradually resolve after stopping immunotherapy, but steroids and hormone replacement may be required – sometimes for extended periods of time – and some side effects can be permanent.
Moffitt’s approach to melanoma immunotherapy
The Cutaneous Oncology Program at Moffitt Cancer Center takes a multispecialty, coordinated approach to the treatment of skin cancers. Our melanoma team, for instance, comprises physicians from every treatment specialty – medical oncology, radiation oncology, surgical oncology, dermatology and more – all trained and experienced in the treatment of melanoma.
Moffitt is a National Cancer Institute-designated Comprehensive Cancer Center, nationally renowned for its comprehensive treatment and supportive care, as well as its groundbreaking research and robust clinical trials program, which includes a wide range of immunotherapy options for melanoma and many other forms of cancer.