Success rates of immunotherapy will depend on the type of therapy and stage of melanoma. It can help prolong life in some people with stage 3 or stage 4 melanoma, including some people who have melanoma that can’t be removed with surgery.
If you have melanoma skin cancer, your doctor might recommend immunotherapy. This type of treatment may help boost your immune system’s response against cancer.
Several types of immunotherapy drugs are available for the treatment of melanoma. In most cases, these drugs are prescribed to people with stage 3 or stage 4 melanoma. But in some cases, your doctor might prescribe immunotherapy to treat less advanced melanoma.
Read on to learn more about the role that immunotherapy may play in the treatment of this disease.
To understand the success rates of immunotherapy, it’s important to differentiate between the different types available. There are three main groups of immunotherapy used to treat melanoma:
- checkpoint inhibitors
- cytokine therapy
- oncolytic virus therapy
Checkpoint inhibitors are drugs that may help your immune system recognize and kill melanoma skin cancer cells.
The Food and Drug Administration (FDA) has approved four types of checkpoint inhibitors for treating melanoma:
- ipilimumab (Yervoy), which blocks the checkpoint protein CTLA-4
- pembrolizumab (Keytruda), which blocks the checkpoint protein PD-1
- nivolumab (Opdivo), which also blocks PD-1
Opdualag , which is used only for metastatic or unresectable melanoma
Your doctor may prescribe one or more checkpoint inhibitors if you have stage 3 or stage 4 melanoma that can’t be removed with surgery. When melanoma can’t be surgically removed, it’s known as unresectable melanoma.
In other cases, they may prescribe checkpoint inhibitors in combination with surgery.
Ipilimumab (Yervoy)
In a review published in 2015, researchers pooled the results of 12 past studies on the checkpoint inhibitor Yervoy. They found that in people with unresectable stage 3 or stage 4 melanoma, 22% of those who received Yervoy were alive 3 years later.
However, some studies have found lower rates of success in people treated with this drug.
When researchers from the EURO-VOYAGE study looked at treatment outcomes in 1,043 people with advanced melanoma, they found that 10.9% who received Yervoy lived for at least 3 years. Eight percent of people who received this drug survived for 4 years or more.
Pembrolizumab (Keytruda)
Research suggests that treatment with Keytruda alone may benefit some people more than treatment with Yervoy alone.
In a
The authors of a more recent study estimated that the 5-year overall survival rate in people with advanced melanoma who were treated with Keytruda was 34%. They found that people who received this drug lived for a median average of about two years.
Nivolumab (Opdivo)
Studies have also found that treatment with Opdivo alone may increase the chances of survival more than treatment with Yervoy alone.
When investigators compared these treatments in people with unresectable stage 3 or stage 4 melanoma, they found that people who were treated with Opdivo alone survived for a median average of about 37 months, or just over 3 years. People who were treated with Yervoy alone survived for a median average of about 30 months.
The same study found that the 6.5-year overall survival rate was
Nivolumab + ipilimumab (Opdivo + Yervoy)
Some of the most promising treatment outcomes for people with unresectable melanoma have been found in people treated with a combination of Opdivo and Yervoy.
In a
Although researchers have linked this combination of medications to improved survival rates, they’ve also found it causes more frequent serious side effects than either medication alone.
Larger studies on this combination therapy are needed.
Treatment with cytokines may help boost your immune system and strengthen its response against cancer.
The FDA has approved three types of cytokines for the treatment of melanoma:
- interferon alfa-2b (Intron A)
- pegylated interferon alfa-2b (Sylatron)
- interleukin-2 (aldesleukin, Proleukin)
Interferon alfa-2b is generally prescribed after melanoma has been removed with surgery. This is known as adjuvant treatment. It may help lower the chances of the cancer returning.
Peginterferon alfa-2b (Sylatron) is
Proleukin is most often used to treat stage 3 or stage 4 melanoma that has spread.
For most people with melanoma, the potential benefits of treatment with cytokine therapy appear to be smaller than those of taking checkpoint inhibitors. However, some people who don’t respond well to other treatments might benefit from cytokine therapy.
In 2010, researchers published a review of studies on interferon alfa-2b in the treatment of stage 2 or stage 3 melanoma. The authors found that patients who received high doses of interferon alfa-2b after surgery had marginally better disease-free survival rates, compared to those who didn’t receive this treatment. They also found that patients who received interferon alfa-2b after surgery had slightly better overall survival rates.
Oncolytic viruses are viruses that have been modified to infect and kill cancer cells. They may also trigger your immune system to attack cancer cells in your body.
Talimogene laherparepvec (Imlygic) is an oncolytic virus that’s
Imlygic is typically prescribed before surgery. This is known as neoadjuvant treatment.
Talimogene laherparepvec (Imlygic)
Research presented at the 2019 European Society for Medical Oncology conference suggests that administering Imlygic before surgically removing melanoma may help some patients live longer.
This study found that among people with advanced stage melanoma who were treated with surgery alone, 77.4% survived for at least 2 years. Among those treated with a combination of surgery and Imlygic, 88.9% survived for at least two years.
More research is needed on the potential effects of this treatment.
Immunotherapy can cause side effects, which vary depending on the specific type and dose of immunotherapy that you receive.
For example, potential side effects include:
- fatigue
- fever
- chills
- nausea
- vomiting
- diarrhea
- skin rash
These are only some of the potential side effects that immunotherapy may cause. Talk to your doctor to learn more about the potential side effects of specific immunotherapy treatments.
The side effects of immunotherapy are usually mild, but in some cases, they can be serious.
If you are experiencing side effects, let your doctor know immediately.
In addition to the immunotherapy treatments approved for treating melanoma, scientists are currently studying other experimental immunotherapy approaches.
Some researchers are developing and testing new types of immunotherapy drugs. Others are studying the safety and efficacy of combining multiple types of immunotherapy. Other researchers are trying to identify strategies for learning which patients are most likely to benefit from which treatments.
If your doctor thinks you might benefit from receiving an experimental treatment or taking part in a research study on immunotherapy, they might encourage you to enroll in a clinical trial.
Before enrolling in any trial, make sure you understand the potential benefits and risks.
To help support your physical and mental health while you undergo immunotherapy or other cancer treatments, your doctor may encourage you to make some lifestyle changes.
For example, they may encourage you to:
- adjust your sleep habits to get more rest
- tweak your diet to get more nutrients or calories
- change your exercise habits to get enough activity, without taxing your body too much
- wash your hands and limit your exposure to sick people to reduce your risk of infection
- develop stress management and relaxation techniques
In some cases, adjusting your daily habits may help you manage side effects of treatment. For example, prioritizing your daily tasks, getting moderate activity, and resting when needed may help you manage fatigue. Eating small meals throughout the day that are nutrient-dense and easy to digest may help you manage your nausea and loss of appetite.
If you need help adjusting your lifestyle habits or managing the side effects of treatment, your doctor may refer you to a professional for support. For example, a dietitian can help you adjust your eating habits.
Your outlook with melanoma cancer depends on many factors, including:
- your overall health
- the stage of cancer you have
- the size, number, and location of tumors in your body
- the type of treatment you receive
- how your body responds to treatment
Your doctor can help you learn more about your condition and long-term outlook. They can also help you understand your treatment options, including the effects that treatment might have on the length and quality of your life.