Immunotherapy helps boost a person’s immune system to better attack the cancer. Many types of immunotherapy are used for people with melanoma.
Immune checkpoint inhibitors for advanced melanoma
These drugs can help the immune system to better “see” melanoma cells and attack them:
- Pembrolizumab (Keytruda)
- Nivolumab (Opdivo)
- Ipilimumab (Yervoy)
These drugs are given as IV (intravenous) infusions in patients with melanomas that can’t be removed by surgery or that have spread to other parts of the body. Doctors are also looking at using these drugs for earlier stage melanomas.
Common side effects from these drugs can include feeling tired, nausea, diarrhea, joint pain, skin rash, and itching. These drugs sometimes cause the immune system to attack other parts of the body, which can cause serious problems. If problems do arise, treatment may need to be stopped and you may get drugs to suppress your immune system.
Cytokines for advanced melanoma
Cytokines are proteins in the body that “turn on” the immune system. Man-made versions of cytokines, such as interferon-alfa and interleukin-2 (IL-2), are sometimes used to help shrink advanced melanomas. They are given as intravenous (IV) infusions or as injections under the skin.
Side effects can include flu-like symptoms like fever, chills, aches, and severe tiredness. IL-2 in high doses can cause fluid to build up in the body so that the person swells up and can feel quite sick. It is given only in centers experienced with this type of treatment.
Interferon-alfa as adjuvant therapy
Patients with thicker melanomas often have cancer cells that have spread to other parts of the body. Even if it looks as if all the cancer has been removed, some of these cells may be left behind. Interferon-alfa can be used as an added (adjuvant) therapy after surgery to try to prevent these cells from spreading and growing. This might help keep the melanoma from coming back for a time, but it is not yet clear if it improves survival.
High doses of interferon must be used for this. Many patients can’t take the side effects of these high doses, such as fever, chills, aches, severe tiredness, and effects on the heart and liver. Patients having this treatment should be closely watched by a cancer doctor who has experience with this treatment.
Viruses are germs that can infect and kill cells. Some viruses can be altered in the lab so that they infect and kill mainly cancer cells. Along with killing the cancer cells, the viruses can also alert the immune system to attack the cells.
Talimogene laherparepvec (Imlygic) is a virus that can be used to treat melanomas in the skin or lymph nodes that can’t be removed with surgery. The virus is injected right into the tumors, usually every 2 weeks. This treatment can sometimes shrink these tumors, but it has not been shown to shrink tumors in other parts of the body. It’s also not clear if this treatment can help people live longer. Side effects can include flu-like symptoms and pain at the injection site.
BCG (Bacille Calmette-Guerin) vaccine
BCG is a germ related to the one that causes tuberculosis (TB). BCG does not cause serious disease in humans, but it does “turn on” the immune system. It can be used to help treat some melanomas by injecting it right into the tumors.
Imiquimod (Zyclara) is a drug that is applied as a cream. It causes an immune response against skin cancer cells. Some doctors may use imiquimod for very early-stage melanomas in sensitive areas on the face that might be scarred by surgery. Some people have serious skin reactions to this drug.
Not all doctors agree on whether imiquimod should be used for melanoma. It is not used for more advanced melanomas.
Some newer types of immunotherapy have shown promise in treating melanoma in early studies. (See “What’s new in research and treatment of melanoma skin cancer?”)
To learn more about this type of treatment, see Cancer Immunotherapy.
Last Revised: 02/01/2016