Immunotherapy is one of several types of treatment considered to be standard of care for melanoma. The common types of treatment are the following:
- Surgery is the removal of the melanoma and surrounding normal tissue.
- Chemotherapy includes drugs to stop the growth of cancer cells. How it is given depends on the type and stage of the cancer.
- Radiation therapy is the use of high-energy X-rays or other types of radiation to kill cancer cells or stop them from growing.
- Targeted therapy includes drugs or other substances to attack cancer cells directly, usually by targeting a specific abnormal gene or protein.
- Immunotherapy activates the body’s immune system to enable immune cells to attack and destroy cancer cells.
The use of the body’s own immune system makes immunotherapy fundamentally different from other cancer treatments. Many immunotherapy strategies currently exist (see Table 1). Additional immunotherapies, used alone and in conjunction with other treatments, are being studied in clinical trials.
Immunotherapy depends on a functioning immune system, so it will likely be important to make sure that you do not have an autoimmune disorder or are not taking any immunosuppressive medications. After taking into consideration these and other factors, such as your overall health, type and stage of your melanoma and your treatment history, your doctor will recommend one or a combination of treatments.
Once treatment begins, monitoring is key. More monitoring and follow-up occur with immunotherapy than with most other forms of treatment. You will likely undergo testing to allow your doctor to evaluate how well treatment is working by measuring the size of the tumor as treatment progresses.
If immunotherapy is not suggested for you, do not be disappointed. All of the approved treatments for melanoma are extremely effective strategies. In addition, you may be a candidate for a clinical trial that offers access to a leading-edge treatment that is not yet available. Ask your doctor about all your options, taking into consideration possible side effects, before making any treatment decisions.
Words To Know
CTLA-4 (cytotoxic T-lymphocyte-associated antigen-4) – A protein receptor found on the surface of T cells. This protein is part of the CTLA-4 checkpoint pathway, which can shut down an immune system response in its early stages. Certain cancer cells have the ability to turn on this checkpoint, which stops the immune response against the cancer cells.
Checkpoint inhibitors – Drugs that block the activation of specific immune checkpoint pathways and prevent T cells from shutting down.
Immune checkpoint pathways – The system of checks and balances in place to prevent overactivation of the immune system. Different pathways function at different stages of the immune response to help regulate the length and intensity of T cell activity; turning on an immune checkpoint typically results in shutting down the immune system response.
Interferon – A protein released by immune cells that helps regulate different immune cell activity; types of interferon include alfa, beta, gamma and lambda. Different types help regulate different functions, including prompting increased T cell activity, stimulating natural killer cells or affecting certain cell functions that influence tumor cell growth. Laboratory-made versions of the IFN-alfa protein are currently FDA-approved to treat certain types of cancer.
Interleukin – A protein produced by cells of the immune system that helps regulate the production of certain immune cells, how they function during an immune response and their production of cytokines. The laboratory-made version of this protein, aldesleukin (Proleukin), is currently FDA-approved to treat metastatic melanoma and metastatic renal cell carcinoma (kidney cancer).
Oncolytic virus – A virus that can infect and multiply within cancer cells, leading them to die. These viruses may be manufactured or naturally occurring, and can be used to target and destroy specific tumor cells. They may also induce an immune response.
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