Immunotherapy for melanoma
Certain drugs, such as imiquimod or BCG vaccine, can boost the body’s natural immune response against melanoma tumors, and may be applied to or injected directly into the melanoma tumor. Alpha-interferon (IFN-alpha), interleukin-2 (IL-2), and ipilimumab are used to treat some cases of advanced stage melanoma, and stimulate the immune system to attack melanoma cells.
Ipilimumab (Yervoy®) is a form of cancer immunotherapy approved by the FDA for the treatment of metastatic melanoma. Ipilimumab is a monoclonal antibody that targets CTLA-4, a protein that helps to regulate the immune system by suppressing the activity of T cells. By blocking the action of CTLA-4, Ipilimumab acts to take the brakes off the immune system, allowing it to fight the cancer cells. This agent is used to treat melanoma that has spread or that cannot be treated by surgery.
In a clinical trial, ipilimumab helped some patients with metastatic melanoma to live longer. However, this form of immunotherapy can also lead to serious immune-related side effects in the intestines, liver, hormone-producing glands, eyes, nerves, skin and other organs, so your doctors at CTCA may discuss whether this drug is right for you. If it is, your CTCA care team will work with you to reduce or prevent these potentially serious side effects.
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, only they’ve mutated and changed so that once-healthy lung cells no longer behave like lung 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 through the PD-1 receptor, which tricks the body’s police force into thinking cancer cells are normal. Certain immunotherapy drugs work by blocking this evasive maneuver with a PD-1 inhibitor, which quiets the PD-1 receptor, allowing the cancer cells to be exposed as invaders, and triggering the immune system to send out an alert and launch a system-wide attack.
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.