What to know about melanoma medication

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Immunotherapy works by helping a person’s immune system recognize and eliminate cancer cells more effectively. Doctors can also use it:

• to treat melanoma that doctors cannot remove surgically
• to treat melanoma that has spread to other parts of the body
• alongside surgery to reduce the likelihood of the cancer returning

There are different types of immunotherapy medications.

Checkpoint inhibitors

Immune system cells have proteins on their surface that allow the cell to activate or deactivate. Doctors call these checkpoint proteins.

Melanoma cells sometimes use checkpoint proteins to help prevent the immune system from attacking them.

Some immunotherapy drugs block specific checkpoint proteins, allowing the immune system to target melanoma cells. Healthcare professionals call these drugs checkpoint inhibitors, and they include:

• PD-1 inhibitors: Doctors may prescribe PD-1 inhibitors, such as pembrolizumab (Keytruda) and nivolumab (Opdivo), to treat melanoma. They block a protein on T cells called PD-1. T cells are a type of white blood cell.
• CTLA-4 inhibitor: The CTLA-4 inhibitor doctors use to treat melanoma is ipilimumab (Yervoy). This drug blocks CTLA-4, which is a protein present in T cells. Healthcare professionals may prescribe it alongside a PD-1 inhibitor, which can increase the likelihood of the tumor shrinking.
• PD-L1 inhibitors: PD-L1 is a protein present in certain immune and tumor cells. Atezolizumab (Tecentriq) is a PD-L1 inhibitor that doctors may recommend to treat melanoma.
• LAG-3 inhibitor: LAG-3 is a protein present in some immune system cells. Relatlimab is a LAG-3 inhibitor that healthcare professionals may recommend. Doctors may use it alongside Opdivo to make the combination Opdualag.

Healthcare professionals administer these medications through intravenous (IV) infusion, which involves injecting them into someone’s vein.

Interleukin-2 (IL-2)

IL-2 helps stimulate the development of immune system cells. The National Cancer Institute notes that IL-2 is especially effective at boosting lymphocytes, a type of white blood cell able to kill cancerous cells.

Aldesleukin (Proleukin) is a synthetic form of IL-2 that healthcare professionals administer by IV infusion.

Bispecific T cell engager (BiTE)

Tebentafusp (Kimmtrak) is a BiTE that doctors may prescribe for eye melanoma. It helps link melanoma cells with T cells by linking a surface marker on the melanoma to a protein on the T cell. This helps the T cell find the melanoma cell and destroy it.

A healthcare professional will test a person for this marker before prescribing them with Kimmtrak. If someone has this marker, a healthcare professional may give them Kimmtrak through IV infusion.

Imiquimod cream

Imiquimod is a cream for a person’s skin. It helps stimulate an immune response in a specific area of the skin.

A doctor may use imiquimod to treat early stage melanomas on a person’s face. They may also use it to treat melanomas that have spread across the skin’s surface.

Some melanoma cells have certain mutations that make them different from typical cells. Targeted therapy targets cells with these abnormalities and helps destroy them.

It can be beneficial as it only targets cancerous cells and generally does not affect healthy cells. Targeted therapy drugs can also stop tumors from growing.

BRAF inhibitors

The American Cancer Society (ACS) states that around half of all melanomas have a mutation in the BRAF gene, an altered gene that helps them grow.

BRAF inhibitors, such as encorafenib (Braftovi), vemurafenib (Zelboraf), and dabrafenib (Tafinlar), block proteins that the mutant BRAF gene makes. This helps shrink or slow the growth of the melanoma.

These medications may come in the form of pills or capsules.

MEK inhibitors

A gene called MEK can work alongside the BRAF gene. Drugs that block the MEK gene can help treat melanomas with BRAF mutations.

MEK inhibitors can help treat melanomas that have spread or are not surgically removable. They come in pill form and include trametinib (Mekinist), binimetinib (Mektovi), and cobimetinib (Cotellic).

The ACS notes that MEK inhibitors are a common treatment option alongside BRAF inhibitors. This helps shrink the tumor for longer and reduces side effects.

Healthcare professionals typically use immunotherapy and targeted therapy medications, rather than chemotherapy drugs. This is because they are usually more effective.

However, doctors may prescribe chemotherapy medications in some cases, for example, if someone has advanced melanoma that has not responded to other treatments.

Chemotherapy drugs for melanoma may include:

• nab-paclitaxel
• dacarbazine
• cisplatin
• temozolomide
• carboplatin
• paclitaxel

There are various medications that a healthcare professional can use to treat someone with melanoma. These include targeted therapy drugs, immunotherapy medications, and chemotherapy drugs.

However, doctors typically prescribe immunotherapy or targeted therapy medications, as they are usually more effective than chemotherapy drugs.

A person with melanoma should speak with a doctor about which medications may work best for them. They should also speak with a healthcare professional if their current treatment is ineffective or causing side effects.