Melanoma Skin Cancer Overview

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Treating Skin Cancer - Melanoma TOPICS

Immunotherapy for melanoma skin cancer

Immunotherapy helps boost a person’s immune system to better attack the cancer. There are many types of immunotherapy used for people with advanced melanoma.

Ipilimumab and pembrolizumab for advanced melanoma

Ipilimumab (Yervoy) and pembrolizumab (Keytruda) are both man-made versions of a certain type of immune system protein (monoclonal antibodies). They can boost the immune response against melanoma cells in the body.

These drugs are given as IV (intravenous) infusions in patients with melanomas that can’t be removed by surgery or that have spread to other parts of the body. Doctors are also looking at using these drugs for earlier stage melanomas as well.

Common side effects from these drugs can include feeling tired, nausea, diarrhea, joint pain, skin rash, and itching. In some cases, these drugs can cause the immune system to attack other parts of the body, which can cause serious problems. If problems do arise, treatment may need to be stopped and you may get drugs to suppress your immune system.

Cytokines for advanced melanoma

Cytokines are proteins in the body that “turn on” the immune system. Man-made versions of cytokines, such as interferon-alfa and interleukin-2 (IL-2), are sometimes used in patients with melanoma. They are given as intravenous (IV) infusions or as injections under the skin. They can help shrink advanced melanomas in some patients.

Side effects may include flu-like symptoms like fever, chills, aches, and severe tiredness. IL-2 in high doses can cause fluid to build up in the body so that the person swells up and can feel quite sick. It is given only in centers experienced with this type of treatment.

Interferon-alfa as adjuvant therapy

Patients with thicker melanomas often have cancer cells that have spread to other parts of the body. Even after it looks as if all the cancer has been removed, some of these cells may remain. Interferon-alfa can be used as an added (adjuvant) therapy after surgery to try to prevent these cells from spreading and growing. This might help keep the melanoma from coming back quickly, but it is not yet clear if it improves survival.

In order to work, high doses of interferon must be used. Many patients can’t take the side effects of these high doses. Side effects may be fever, chills, aches, severe tiredness, and effects on the heart and liver. Patients having this treatment should be closely watched by a cancer doctor who has experience with this treatment.

BCG (Bacille Calmette-Guerin) vaccine

BCG is a germ related to the one that causes tuberculosis (TB). BCG does not cause serious disease in humans, but it does “turn on” the immune system. It is sometimes used to help treat stage III melanomas. It is given as a shot (injection) right into the tumors.

Imiquimod cream

Imiquimod (Zyclara) is a drug that is used as a cream to cause an immune response against skin cancer cells. For very early (stage 0) melanomas in sensitive areas on the face that may be scarred by surgery, some doctors may use imiquimod. The cream is used anywhere from once a day to 2 times a week for around 3 months. Some people may have serious skin reactions to this drug.

Not all doctors agree on whether it should be used for melanoma. Imiquimod is not used for more advanced melanomas.

Newer treatments

Some newer types of immunotherapy have shown promise in treating melanoma in early studies. At this time they are available only through clinical trials. (See “What’s new in research and treatment of melanoma skin cancer?”)


Last Medical Review: 02/19/2014
Last Revised: 09/16/2014