Melanoma: A Model of Immunotherapy Success
Melanoma is a malignant tumor of melanocytes, most often caused by UV exposure. While once lethal in its metastatic form, it has become a showcase for breakthroughs in immunotherapy and targeted therapy.
Immunotherapy
Checkpoint inhibitors have revolutionized melanoma care:
- Anti-PD-1 agents: nivolumab, pembrolizumab
- Anti-CTLA-4: ipilimumab (often used in combination with PD-1 blockade)
These agents are used in metastatic, adjuvant, and even neoadjuvant settings.
Targeted Therapy
Approximately 40–50% of melanomas harbor BRAF V600E/K mutations. Targeted therapies include:
- BRAF inhibitors: dabrafenib, vemurafenib
- MEK inhibitors: trametinib, cobimetinib These are used in combination and offer rapid tumor regression.
Future Directions
- Neoadjuvant immunotherapy is showing promising pathologic response rates.
- LAG-3 inhibitors (e.g., relatlimab) add new depth to checkpoint blockade strategies.
- Adoptive cell therapy and intralesional immunotherapy are under investigation.