REVIEW ARTICLE
Advances in the Systemic Treatment of Metastatic Melanoma
By Melinda Yushak, MD, MPH1,
Harriet M. Kluger, MD1,
Mario Sznol, MD1 |
May 15, 2013
1Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut
ABSTRACT: Prior to 2011, the only commercially available agents commonly used to treat metastatic melanoma—including dacarbazine(Drug information on dacarbazine), temozolomide(Drug information on temozolomide) (Temodar), fotemustine, carboplatin(Drug information on carboplatin), paclitaxel(Drug information on paclitaxel),
and interleukin-2—demonstrated limited efficacy, and no study involving
these agents had shown an improvement in overall survival. The standard
of care for the treatment of metastatic melanoma was radically changed
by the subsequent approval of two agents, ipilimumab (Yervoy) and
vemurafenib (Zelboraf), both of which improved survival in randomized
phase III trials. Within the relatively short time that ipilimumab and
vemurafenib have been commercially available, phase II data for the
investigational agents nivolumab and MK-3475, for the combination of
dabrafenib and trametinib, and for adoptive cell therapy strongly
suggest even further improvements in treatment outcomes. Within this
rich context of effective agents, the challenge for clinicians and
investigators will be to develop predictive biomarkers of response, the
optimal sequence of therapy for individual patients, and effective
combinations. An additional challenge will be to find the appropriate
venue and populations to test promising new agents arising from
substantial advances in our understanding of molecular alterations in
melanoma cells, of mechanisms of resistance to current agents, and of
tumor-host immune interactions.
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GO TO ARTICLE FOR FURTHER DETAILS! http://www.cancernetwork.com/melanoma-skin-cancer/content/article/10165/2141794?GUID=EA9DCCFA-913B-4D15-898B-076D1A88BBD6&rememberme=1&ts=16052013
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