The primary treatment for melanoma is surgical removal of the tumor. Although requiring further clinical trials, in some cases, immunotherapy or targeted therapy may be used in the treatment of advanced stages of melanoma.

Many combination therapies are currently in trials. Advanced melanoma patients should be considered for enrollment in a trial for their own benefit as well as for the advancement of melanoma treatment. Thus far, no single investigative approach stands out as highly effective; however, they all hold promise with rare patients showing durable responses. Most treatment protocols are evaluating combinations of adjuvant therapies, hoping to achieve a synergistic effect. Ongoing research into the biology of melanoma continues to suggest new drug targets that will block tumor progression or enhance host response.

Immunotherapy

Immunotherapy involves using medications or substances made by the body to increase or restore the body's natural defenses against cancer. It is also called biological response modifier (BRM) therapy . Examples include interferon, interleukin-2, ipilimumab, and melanoma vaccines.

Side effects include chills, fever, aches, depression, and fatigue. At times, these can be a significant barrier to successful treatment.

Targeted Therapy

About half of melanomas have a gene mutation known as BRAF. This gene causes the body to make proteins that accelerate the growth of cancer cells. Targeted therapy uses medications to seek out the cells with the BRAF mutation and destroy them. Targeted therapy medications include:

  • Vemurafenib (Zelboraf)
  • Dabrafenib
  • Trametinib

Although these medications are not a cure for advanced melanoma, it can increase a patient's survival rate. The most common side effects are joint pain, fatigue, hair loss, rash, itching, sensitivity to the sun, and nausea.

Promising Therapies

Researchers are currently studying new drugs and therapies to treat melanoma. Therapies being studied include:

  • Melanoma vaccines—researchers are studying vaccines that may help the body fight melanoma; currently only available in clinical trials
  • Tumor infiltrating lymphocytes (TILs)—special cells that show promise in shrinking tumors are being studied
  • Genetically altered T-cells—cells in the body that when altered may be able to shrink tumor cells
  • Gene therapy—researchers are studying ways to alter genes so that they fight melanoma more effectively