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What to Know about Immunotherapy for Melanoma

Immunotherapy uses substances that boost your body’s own immune system to fight cancer. Sometimes these substances are called biologicals. The substances help your immune cells better recognize and attack the cancer cells.

Your doctor may suggest immunotherapy if one of these cases applies to you:

  • You have advanced melanoma. In this case, the goal of immunotherapy is to help shrink the tumor. You may have this treatment alone or along with chemotherapy. Or your doctor may suggest a clinical trial of immunotherapy to help you.

  • You have had surgery to remove the melanoma. Immunotherapy after surgery may delay the time before the cancer comes back, although it's not clear if it helps people live longer.

These are the types of immunotherapy used for melanoma:

  • Anti-CTLA-4 therapy 

  • Interferon alpha

  • Interleukin-2

  • Bacille Calmette-Guerin (BCG) vaccine

Melanoma-specific vaccines are another way to fight the cancer. These are not yet proven, though, and are only available in clinical trials. They are meant to trigger the immune system to fight off the cancer.

Types of immunotherapy for melanoma

Immunotherapy gets your immune system to more effectively attack cancer cells. There are a few types of immunotherapy that may be used to treat melanoma.

Anti-CTLA-4 therapy 

Ipilimumab (Yervoy) is a monoclonal antibody that boosts the immune system by targeting CTLA-4, a protein that normally suppresses the T-cell immune response. CTLA-4 might help melanoma cells to survive, so targeting this protein is one way to make the immune system more effective at fighting melanoma. This drug is used to treat advanced melanoma. It is given as an intravenous (IV) infusion, typically once every three weeks for four treatments.

Side effects of ipilimumab can sometimes be severe. In some cases the immune system may attack other parts of the body, such as the intestines, liver, nerves, skin, eyes, hormone-making glands, or other organs. It is important to report any side effects to your doctor or nurse right away. 

Cytokine therapy

Cytokines are proteins that trigger your immune system. The FDA has approved these two cytokines for melanoma:

  • Interferon-alpha

  • Interleukin-2

These drugs are given by IV infusions or as injections under the skin. Doctors use them to boost immunity in a general way. For example, interleukin-2 is an agent that prompts the growth of certain white blood cells.

Side effects from cytokine therapy, including flu-like symptoms and fluid buildup in the body, can be serious. Some people can't take the high doses needed for treatment. But side effects usually improve after the treatment is done.  

Vaccine therapy

Bacille Calmette-Guerin (BCG) is a germ related to the one that causes tuberculosis. BCG does not cause serious disease in humans, but it does activate the immune system. The BCG vaccine can work like a cytokine, enhancing the entire immune system. It is sometimes used to help treat melanomas by injecting it directly into tumors. 

Several types of vaccines that target melanoma cells more specifically are under development, but so far they are considered experimental and are only available in clinical trials. The most common types of vaccines are fragments of proteins called peptides and killed cancer cells. Doctors generally inject them under the skin with other immune stimulators. The theory is that they stimulate an immune reaction to the vaccine that will also work against the cancer cells in the body. 


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