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Immunotherapy for melanoma


Immunotherapy for melanoma

Immunotherapy is designed to help the immune system identify and attack cancer cells. Several types of immunotherapy may be options to treat melanoma:

Checkpoint inhibitors work by targeting signaling proteins that allow cancer cells to disguise themselves as healthy cells. The U.S. Food and Drug Administration has approved the checkpoint inhibitor drugs ipilimumab (Yervoy®), pembrolizumab (Keytruda®) and nivolumab (Opdivo®) to treat melanoma. Ipilimumab targets the CTLA-4 cell receptor; pembrolizumab and nivolumab target the PD-1 cell receptor. These protein receptors help to regulate the immune system by suppressing the activity of T-cells.

Cytokines are molecules that help regulate immune activity. The drugs alpha-interferon (IFN-alpha) and interleukin-2 (IL-2) are cytokines that may be used to treat some cases of advanced melanoma. These drugs stimulate the rapid growth and activity of immune cells so that they quickly attack the cancer cells.

Immunotherapy may not be recommended for all patients. Because they stimulate the immune system, immunotherapy treatments may also lead to side effects, such as skin rashes or gastrointestinal problems.

What is immunotherapy? 

Immunotherapy is a broad category of anti-cancer therapies that use the body’s immune system to fight cancer cells. These cells are different from normal cells, in that they do not die normally. Think of these rapidly-dividing cells like an out-of-control copy machine that won’t stop creating images. These abnormal cells frequently change, or “mutate,” to evade the immune system. Immunotherapy drugs are designed to alert the immune system about these mutated cells so it can locate and destroy them. 

Immunotherapies fall into three general categories: checkpoint inhibitors, which disrupt signals that allow cancer cells to hide from an immune attack; cytokines, protein molecules that help regulate and direct the immune system; and cancer vaccines, which are used to both treat and prevent cancer by targeting the immune system. 

How does immunotherapy spark the immune system to help fight cancer?

The immune system is always on patrol, like a police force charged with ridding the body of foreign invaders, such as viruses, bacteria or fungi. Lymph nodes, which make up most of the immune system, serve as police stations throughout the body. White blood cells, such as “T cells,” fight infection and cancer. They are the police officers. When a foreign invader is detected, the entire immune system is alerted through chemical signals, just as a police station would radio police officers to alert them about a problem. 

Cancer cells are not recognized as invaders because they are the body’s own cells that have mutated, so that once-healthy cells no longer behave like normal cells. The immune system doesn’t recognize this distinction, allowing these dangerous cells to grow, divide and spread throughout the body. One way cancerous cells stay hidden is by sending signals to the PD-1 CTLA-4 receptors at certain checkpoints on immune cells. Those signals trick the body’s police force into thinking the cancer cells are normal. Immunotherapy drugs known as checkpoint inhibitors are designed to disrupt those signals, allowing the cancer cells to be exposed as invaders and triggering an immune system response. Cytokines and cancer vaccines are other types of immunotherapies used to generate an immune response by helping the body recognize cancer cells.

Experienced care team

With our team approach to care, our doctors and clinicians work together to come up with treatment options that meet your needs. Immunotherapy may be an option for you if you have breast, prostate, brain, kidney or spinal cancer, along with non-Hodgkin lymphoma, leukemia or melanoma. The treatment may work better for some cancers, so your doctor would monitor your progress closely and may pair immunotherapy with other treatments.

Personalized treatment approach

Patients and their caregivers are the ones who ultimately decide which treatment they want to pursue. Our clinicians are sensitive to your concerns and work to design treatment options that are appropriate for your needs and goals. We will provide you with the information you need to make an informed decision about immunotherapy.

Managing side effects

Immunotherapy can cause a variety of side effects, including fatigue, nausea, mouth sores, diarrhea, high blood pressure and fluid buildup, usually in the legs. Breast cancer patients, in particular, may experience fever, chills, pain, weakness, vomiting, headaches and rashes. The side effects of immunotherapy generally become less severe after the first treatment.

Throughout your treatment, your care team will provide integrative oncology services, including nutrition therapy, naturopathic medicine, pain management, oncology rehabilitation, mind-body medicine and spiritual support. These therapies can help reduce side effects and improve your overall quality of life during immunotherapy.