{"id":2093,"date":"2019-05-30T20:09:59","date_gmt":"2019-05-30T20:09:59","guid":{"rendered":"http:\/\/scfredesignpro.wpengine.com\/?page_id=2093"},"modified":"2025-04-22T14:43:40","modified_gmt":"2025-04-22T14:43:40","slug":"melanoma-treatments","status":"publish","type":"page","link":"https:\/\/www.skincancer.org\/skin-cancer-information\/melanoma\/melanoma-treatments\/","title":{"rendered":"Melanoma Treatment"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_section][vc_row][vc_column][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\">Melanoma\u00a0<span style=\"color: rgba(50,63,74,0.65);\">Treatment<\/span><\/h1>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column offset=&#8221;vc_col-lg-offset-1 vc_col-lg-10&#8243;][vc_custom_heading text=&#8221;Historic Progress. New Options. More Hope.&#8221; font_container=&#8221;tag:h2|text_align:center&#8221; use_theme_fonts=&#8221;yes&#8221;][\/vc_column][\/vc_row][\/vc_section][vc_section][vc_row][vc_column width=&#8221;9\/12&#8243;][vc_column_text el_class=&#8221;large&#8221;]While melanoma is one of the most dangerous forms of skin cancer, promising new treatment options are improving quality of life and increasing survival rates for patients with advanced melanoma.<\/p>\n<p>If you\u2019ve been diagnosed, your treatment choices depend on the <a href=\"http:\/\/skincancer.org\/skin-cancer-information\/melanoma\/the-stages-of-melanoma\/\">stage of the disease<\/a>, the location of the tumor and your overall health. Options include:<\/p>\n<ul class=\"ul1\">\n<li class=\"li1\"><a href=\"#surgical\">Surgical removal of the melanoma<\/a><\/li>\n<li class=\"li1\"><a href=\"#immunotherapy\">Immunotherapy<\/a><\/li>\n<li class=\"li1\"><a href=\"#targeted\">Targeted therapy<\/a><\/li>\n<li class=\"li1\"><a href=\"#chemotherapy\">Chemotherapy<\/a><\/li>\n<li class=\"li1\"><a href=\"#radiation\">Radiation<\/a><\/li>\n<\/ul>\n<p>Ask your doctor to clearly explain the options that might work best for you, including details about the benefits and risks.[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/4&#8243;][vc_single_image image=&#8221;2995&#8243; img_size=&#8221;medium&#8221;][\/vc_column][\/vc_row][\/vc_section][vc_section full_width=&#8221;stretch_row&#8221; content_placement=&#8221;middle&#8221; css=&#8221;.vc_custom_1532456871168{background-color: #323f4a !important;}&#8221;][vc_row][vc_column width=&#8221;1\/4&#8243; el_class=&#8221;subpage-nav&#8221;][vc_btn title=&#8221;Overview&#8221; style=&#8221;custom&#8221; custom_background=&#8221;#323f4a&#8221; custom_text=&#8221;#ffcc42&#8243; shape=&#8221;square&#8221; size=&#8221;lg&#8221; align=&#8221;center&#8221; i_align=&#8221;right&#8221; i_icon_fontawesome=&#8221;fa fa-arrow-right&#8221; add_icon=&#8221;true&#8221; link=&#8221;url:http%3A%2F%2Fwww.skincancer.org%2Fskin-cancer-information%2Fmelanoma%2F|title:melanoma%20overview||&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; el_class=&#8221;subpage-nav&#8221;][vc_btn title=&#8221;Warning Signs&#8221; style=&#8221;custom&#8221; custom_background=&#8221;#323f4a&#8221; custom_text=&#8221;#ffcc42&#8243; shape=&#8221;square&#8221; size=&#8221;lg&#8221; align=&#8221;center&#8221; i_align=&#8221;right&#8221; i_icon_fontawesome=&#8221;fa fa-arrow-right&#8221; add_icon=&#8221;true&#8221; link=&#8221;url:http%3A%2F%2Fwww.skincancer.org%2Fskin-cancer-information%2Fmelanoma%2Fmelanoma-warning-signs-and-images%2F|title:melanoma%20warning%20signs||&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; el_class=&#8221;subpage-nav&#8221;][vc_btn title=&#8221;Risk Factors&#8221; style=&#8221;custom&#8221; custom_background=&#8221;#323f4a&#8221; custom_text=&#8221;#ffcc42&#8243; shape=&#8221;square&#8221; size=&#8221;lg&#8221; align=&#8221;center&#8221; i_align=&#8221;right&#8221; i_icon_fontawesome=&#8221;fa fa-arrow-right&#8221; add_icon=&#8221;true&#8221; link=&#8221;url:http%3A%2F%2Fwww.skincancer.org%2Fskin-cancer-information%2Fmelanoma%2Fmelanoma-causes-and-risk-factors%2F|title:melanoma%20risk%20factors||&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; el_class=&#8221;subpage-nav&#8221;][vc_btn title=&#8221;Stages&#8221; style=&#8221;custom&#8221; custom_background=&#8221;#323f4a&#8221; custom_text=&#8221;#ffcc42&#8243; shape=&#8221;square&#8221; size=&#8221;lg&#8221; align=&#8221;center&#8221; i_align=&#8221;right&#8221; i_icon_fontawesome=&#8221;fa fa-arrow-right&#8221; add_icon=&#8221;true&#8221; link=&#8221;url:http%3A%2F%2Fwww.skincancer.org%2Fskin-cancer-information%2Fmelanoma%2Fthe-stages-of-melanoma%2F|title:melanoma%20stages||&#8221;][\/vc_column][\/vc_row][\/vc_section][vc_section][vc_row el_class=&#8221;content-block&#8221; el_id=&#8221;surgical&#8221;][vc_column width=&#8221;1\/3&#8243;][vc_custom_heading text=&#8221;Surgical removal of the melanoma&#8221; font_container=&#8221;tag:h3|text_align:left&#8221; use_theme_fonts=&#8221;yes&#8221;][\/vc_column][vc_column width=&#8221;2\/3&#8243;][vc_column_text]<\/p>\n<h4 class=\"p1\"><span class=\"s1\">Treating early melanoma<\/span><\/h4>\n<p><em>Stage 0 \u201cin situ\u201d and stage I<\/em><\/p>\n<p>Tumors discovered at an <a href=\"http:\/\/skincancer.org\/skin-cancer-information\/melanoma\/the-stages-of-melanoma\/\">early stage<\/a> are confined to the upper layers of the skin and have no evidence of spread. These melanomas are treated by <a href=\"\/treatment-resources\/treatment-glossary\/#excisional-surgery\">excisional surgery<\/a>. Usually, this is the only treatment required. The first step was a biopsy, where the physician removed part or all of the lesion and sent it to a lab for analysis, where the melanoma was diagnosed and staged. For the excisional surgery, the surgeon removes more tissue from the site.<\/p>\n<p>Melanoma in situ (stage 0) is localized to the outermost layer of skin (the epidermis). Stage 0 melanoma is the least challenging to treat and cure. Stage I melanoma has invaded the second layer of skin (the dermis). In both stage 0 and stage I melanoma cases, the physician uses a scalpel to remove any remaining tumor plus a &#8220;safety margin&#8221; of surrounding normal tissue. The margin of normal skin removed depends on the thickness and location of the tumor. After surgery the margins are checked to make sure they are cancer-free. If the margins are cancer-free, no further surgery is necessary.<\/p>\n<p>Surgeons may, under certain circumstances, recommend removal of melanoma by\u00a0<a title=\"http:\/\/skincancer.org\/treatment-resources\/mohs-surgery\/\" href=\"http:\/\/skincancer.org\/treatment-resources\/mohs-surgery\/\">Mohs surgery<\/a>. The procedure is done in stages over a few days to remove all of the cancer cells in layers while sparing healthy tissue and leaving the smallest possible scar. One layer at a time is removed and examined until the margins are cancer-free. New advances in this technique make it easier for the surgeon to spot melanoma cells in the margins.<\/p>\n<p>If a melanoma measures 0.8 mm or more in thickness or has other traits such as ulceration that make it more likely to spread to the lymph nodes, a <a href=\"http:\/\/skincancer.org\/skin-cancer-information\/melanoma\/the-stages-of-melanoma\/slnb\/\">sentinel lymph node biopsy<\/a> (SLNB)\u00a0may be performed at the same time as the surgery to remove the primary tumor.<\/p>\n<h4>Treating intermediate, high-risk melanomas<\/h4>\n<p><em>Stage II<\/em><\/p>\n<p>Since the risk of spreading to local lymph nodes is higher in <a href=\"http:\/\/skincancer.org\/skin-cancer-information\/melanoma\/the-stages-of-melanoma\/\">stage II melanomas<\/a>, a <a href=\"http:\/\/skincancer.org\/skin-cancer-information\/melanoma\/the-stages-of-melanoma\/slnb\/\">sentinel lymph node biopsy<\/a> is often recommended in addition to surgery to remove the original tumor. If melanoma is found in the sentinel node, your physician may examine the rest of the nodes in this lymphatic basin and remove any that contain cancer cells.<\/p>\n<p>After surgery, additional treatment may be recommended, including <a href=\"#immunotherapy\">immunotherapy<\/a> or <a href=\"\/treatment-resources\/treatment-glossary\/#radiation-therapy\">radiation<\/a> to decrease the chance that the melanoma will come back.<\/p>\n<p><a href=\"http:\/\/skincancer.org\/skin-cancer-information\/melanoma\/the-stages-of-melanoma\/slnb\/\"><strong>What is a sentinel lymph node biopsy? <\/strong>Learn more.<\/a><\/p>\n<h4>Treating advanced melanomas<\/h4>\n<p><em>Stage III and stage IV<\/em><\/p>\n<p>Advanced melanomas are those that have spread beyond the original tumor, most often reaching the lymph nodes and\/or distant organs and becoming more difficult to treat.<\/p>\n<p>In recent years, new immunotherapies and targeted therapies have achieved positive results in many patients with stage III and stage IV melanoma.<\/p>\n<p>Patients with stage III melanoma now have options for supplemental or \u201cadjuvant\u201d treatment \u2013 medicines that enhance the effectiveness of surgery, with the goal of preventing or delaying relapse and extending survival, ideally achieving a cure.<\/p>\n<p>After surgery to remove the tumor and in many cases the lymph nodes, stage IV patients have quite a few frontline treatment options that have had considerable success. In many cases, if the first treatment proves ineffective or stops working, other therapies are available. These therapies work by shrinking tumors and halting or slowing disease progression to help extend life by months to years and perhaps even leading to a cure.[\/vc_column_text][\/vc_column][\/vc_row][vc_row el_class=&#8221;content-block&#8221; el_id=&#8221;immunotherapy&#8221;][vc_column width=&#8221;1\/3&#8243;][vc_custom_heading text=&#8221;Immunotherapy&#8221; font_container=&#8221;tag:h3|text_align:left&#8221; use_theme_fonts=&#8221;yes&#8221;][\/vc_column][vc_column width=&#8221;2\/3&#8243;][vc_column_text]<\/p>\n<h4>Revolutionary treatment options<\/h4>\n<p>Pioneering breakthroughs in immunotherapy \u2014 the use of medicines to stimulate a patient\u2019s immune system to destroy cancer cells \u2014 have led to significant progress in treating patients with advanced melanoma.<\/p>\n<p>Immunotherapies boost the body\u2019s ability to fight melanoma and other cancers by using synthetic versions of natural immune system proteins, or by enabling the release of cells that attack tumors. These therapies are effective when used alone or in combinations.<\/p>\n<h4><span class=\"TextRun Highlight SCXW112498619 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW112498619 BCX0\">Immune checkpoint inhibitors<\/span><\/span><\/h4>\n<p>To assure that T cells attack only bacteria and disease and not the body itself, the immune system uses checkpoints, molecules that suppress T cells. T cells are the white blood cells that help protect the body from infection. Checkpoints help keep T cells from attacking normal cells in the body.<\/p>\n<p><span class=\"TextRun Highlight SCXW34949028 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW34949028 BCX0\">Immune checkpoint inhibitors<\/span><\/span> <span class=\"TextRun Highlight SCXW34949028 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW34949028 BCX0\">(<\/span><span class=\"NormalTextRun SCXW34949028 BCX0\">also known as<\/span><span class=\"NormalTextRun SCXW34949028 BCX0\"> checkpoint blockade <\/span><span class=\"ContextualSpellingAndGrammarError SCXW34949028 BCX0\">therapy)<\/span><\/span> are given intravenously to melanoma patients to stop checkpoint molecules from inhibiting T cells. This enables the immune system to release waves of T cells to attack and kill cancer cells.<\/p>\n<p>The following <span class=\"TextRun Highlight SCXW152987793 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW152987793 BCX0\">checkpoint inhibitors<\/span><\/span> are being used for patients with advanced melanoma:<\/p>\n<h4>Cytotoxic T-lymphocyte Antigen-4 (CTLA-4) blocker<\/h4>\n<h5>Treatment overview<\/h5>\n<p>Approved by the FDA in 2011 for patients with stage IV melanoma, <a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#ipilimumab\">ipilimumab<\/a> was the first checkpoint blockade therapy that helped shrink many tumors markedly and extend life for patients with advanced melanoma. Since then, newer immunotherapy drugs have proven even more effective as single therapies (monotherapies), some with less serious side effects.<\/p>\n<h5>Approved medication<\/h5>\n<p><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#ipilimumab\">Ipilimumab (Yervoy\u00ae)<\/a><\/p>\n<h5>How it works<\/h5>\n<p>Ipilimumab targets CTLA-4, a protein on the T cell that functions as a \u201cbrake\u201d to regulate immune system activation. Blocking CTLA-4 allows T cells to attack and destroy tumors.<\/p>\n<p>While ipilimumab is no longer the frontline choice for treating stage IV melanoma, it is often paired with another checkpoint blockade drug, nivolumab, as a combination frontline therapy for stage IV patients, or can be administered if anti-PD-1 treatment has failed.<\/p>\n<h4>PD-1 blockers<\/h4>\n<h5>Treatment Overview<\/h5>\n<p>In 2014, the FDA approved two additional <span class=\"TextRun Highlight SCXW152987793 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW152987793 BCX0\">checkpoint inhibitor<\/span><\/span> drugs for use in patients with melanoma that has spread beyond the lymph nodes or for melanomas that cannot be removed by surgery (stage IV).<\/p>\n<h5>Approved Medications<\/h5>\n<p><a href=\"\/treatment-resources\/treatment-glossary\/#pembrolizumab\">Pembrolizumab (Keytruda\u00ae)<\/a><br \/>\n<a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#nivolumab\">Nivolumab (Opdivo\u00ae)<\/a><\/p>\n<h5>How they work<\/h5>\n<p>PD-1 (programmed death-1), a protein receptor on T cells that binds to a complementary protein called PD-L1 on the surface of other cells, helps keep the immune system in check. Both drugs block PD-1 to release the brakes on T cells and allow them to attach melanoma cells.<\/p>\n<p>These drugs can be used alone (monotherapies), or nivolumab can be used in combination with ipilimumab or relatlimab. They can be used as the first treatment option, before other medicines have been tried, and as a second option when other treatments have failed or stopped working.<\/p>\n<p>In 2017, the FDA approved nivolumab for therapy after tumor removal (known as adjuvant therapy) in stage III patients who have melanoma in the lymph nodes.<\/p>\n<p>In February 2019, the FDA also approved the <span class=\"TextRun Highlight SCXW152987793 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW152987793 BCX0\">checkpoint inhibitor<\/span><\/span> <a href=\"\/treatment-resources\/treatment-glossary\/#pembrolizumab\">pembrolizumab<\/a> for the adjuvant treatment of stage III melanoma that has metastasized to the lymph nodes after tumor removal. The approval was based on phase 3 research demonstrating that pembrolizumab significantly prolonged recurrence-free survival (RFS) in patients with resected, high-risk stage III melanoma. Depending on the patient, either nivolumab or pembrolizumab can now be considered the frontline option for adjuvant treatment of stage III melanoma in patients who do not have a defective BRAF gene. (In those who do have defective BRAF, the combination targeted therapy dabrafenib-trametinib (Tafinlar<b><sup>\u00ae<\/sup><\/b>-Mekinist<b><sup>\u00ae<\/sup><\/b>) can also be considered a frontline option.)<\/p>\n<p>In December 2021, the FDA expanded the approval of pembrolizumab to the adjuvant treatment of stage IIB and IIC melanoma, which have the same high risk for recurrence or death as stage III melanomas. The approval was based on phase 3 research demonstrating that pembrolizumab reduced the risk of disease recurrence or death by 35 percent compared to placebo in patients with surgically removed stage IIB or IIC melanoma. This approval essentially doubled the number of melanoma patients eligible for adjuvant immunotherapy.<\/p>\n<p><span class=\"TextRun Highlight SCXW173370779 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW173370779 BCX0\">In October 2023, the FDA approved nivolumab as an adjuvant treatment for patients with completely resected stage IIB and IIC melanoma. In the phase 3 trial, nivolumab reduced the risk of recurrence, new primary melanoma or death by 58 percent compared to the placebo. And at one year, the RFS was 89 percent versus 79 percent with the placebo.<\/span><\/span><\/p>\n<p><b><span data-contrast=\"auto\">Tumor-derived autologous T cell immunotherapy<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h5><span data-contrast=\"auto\">TREATMENT OVERVIEW<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/h5>\n<p><span data-contrast=\"auto\">In February 2024, the FDA granted accelerated approval to lifileucel (Amtagvi), a cellular therapy for adult patients with unresectable or metastatic melanoma previously treated with a PD-1 blocking antibody and, if BRAF V600 positive, a BRAF inhibitor with or without a MEK inhibitor.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h5><span data-contrast=\"auto\">APPROVED MEDICATION<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/h5>\n<p><a href=\"https:\/\/www.skincancer.org\/treatment-resources\/treatment-glossary\/#1709239844635-89e84921-26ea\"><span data-contrast=\"auto\">Lifileucel (Amtagvi)<\/span><\/a><\/p>\n<h5><span data-contrast=\"auto\">HOW IT WORKS<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/h5>\n<p><span data-contrast=\"auto\">Tumor infiltrating lymphocytes (TILs) are naturally occurring immune cells that can recognize unique tumor markers on cancer cells in the body and attack and kill them. Called tumor-derived autologous T cell immunotherapy, this treatment is designed to enhance the patient\u2019s own TILs outside the body and then deliver them back to the patient to attack the cancer cells.<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h4>Combination immunotherapy<\/h4>\n<p><em>Unprecedented results by pairing therapies<\/em><\/p>\n<h5>Treatment Overview<\/h5>\n<p class=\"p1\">In 2016, the FDA approved the combination\u00a0of <a href=\"https:\/\/www.skincancer.org\/treatment-resources\/treatment-glossary\/#nivolumab-ipilimumab\">nivolumab and ipilimumab<\/a> as a frontline therapy for patients with metastatic or inoperable melanoma. <span class=\"s1\">In 2022, the FDA approved a second combination, <a href=\"https:\/\/www.skincancer.org\/treatment-resources\/treatment-glossary\/#nivolumab-relatlimab\">nivolumab and relatlimab<\/a>, as a frontline therapy for patients with metastatic or inoperable melanoma.<\/span><\/p>\n<h5>Approved medications<\/h5>\n<p class=\"p1\"><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#nivolumab-ipilimumab\">Nivolumab-Ipilimumab (Opdivo\u00ae &#8211; Yervoy\u00ae)<\/a><br \/>\n<a href=\"https:\/\/www.skincancer.org\/treatment-resources\/treatment-glossary\/#nivolumab-relatlimab\">Nivolumab-Relatlimab (Opdualag\u00ae), Combination<\/a><\/p>\n<h5>How they work<\/h5>\n<p class=\"p1\"><span class=\"s1\">By pairing nivolumab and ipilimumab,<\/span> two successful checkpoint blockade therapies, researchers have created another treatment option that has proven even more effective in shrinking tumors and prolonging life than either drug therapy used on its own, though adverse reactions with the combination medicine are also stronger than with either medicine alone.<\/p>\n<p class=\"p1\"><span class=\"s1\">Similarly, pairing nivolumab and relatlimab proved to be a more effective treatment option than nivolumab therapy alone. Relatlimab, only FDA-approved in this combination, blocks the LAG-3 protein receptor on T cells, thus preventing T cells from binding to a complementary protein on the surface of tumor cells. Just like PD-1 inhibition, this releases the breaks on the immune system and allows T cells to attack melanoma cells.<\/span><\/p>\n<h4 class=\"p1\"><span class=\"s1\">Oncolytic virus therapy<\/span><\/h4>\n<h5>Treatment Overview<\/h5>\n<p>In 2015, the FDA approved the oncolytic virus therapy <a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#talimogene\">talimogene laherparepvec (Imlygic\u00ae)<\/a>, also known as T-VEC, to treat the skin and lymph nodes of patients with advanced melanomas that cannot be surgically removed.<\/p>\n<h5>Approved Medications<\/h5>\n<p class=\"p1\"><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#talimogene\">Talimogene laherparepvec, or T-VEC (Imlygic\u00ae)<\/a><\/p>\n<h5>How it works<\/h5>\n<p>This new class of immunotherapy, injected directly into tumors, uses a lab-altered virus, known as an oncolytic virus, that is specifically programmed to infect and kill cancer cells exclusively. At the same time, an immune-boosting protein in the virus accelerates the body\u2019s immune response to the tumors. The medicine\u2019s most immediate effect is to shrink the size of injected tumors, but the secondary goal is for the drug to work systemically, attacking the cancer throughout the body.<\/p>\n<p>Similar viruses are now being studied, with the goal of producing more options for melanoma patients whose diseases have spread or returned.<\/p>\n<h4>Adoptive cell transfer<\/h4>\n<h5>How it works<\/h5>\n<p>This experimental new avenue uses white blood cells called tumor-infiltrating lymphocytes (TILs) to attack melanoma. The treatment is currently being explored in clinical trials on patients with advanced melanomas that have not responded to other treatments. Most often, the lymphocytes found to be attacking the melanoma are extracted from the patient, cultured in massive numbers in a lab and then returned to the patient.<\/p>\n<h4>Early immunotherapies<\/h4>\n<h5>Treatment Overview<\/h5>\n<p>Older forms of immunotherapy once used in high-risk stage II, III and IV melanoma patients have since been replaced as frontline treatments by newer, more effective treatment options.<\/p>\n<h5>Approved medications<\/h5>\n<p class=\"p1\"><a href=\"\/treatment-resources\/treatment-glossary\/#interferon\">Interferon alfa-2b<\/a><br \/>\n<a href=\"\/treatment-resources\/treatment-glossary\/#interleukin-2\">Interleukin-2<\/a><br \/>\n<a href=\"\/treatment-resources\/treatment-glossary\/#pegylated\">Pegylated Interferon alfa-2b<\/a><\/p>\n<h5>How they work<\/h5>\n<p>These early forms of immunotherapy worked by boosting the immune system\u2019s ability to fight disease. They are less used today because of the superior results of the newer therapies.[\/vc_column_text][\/vc_column][\/vc_row][vc_row el_class=&#8221;content-block&#8221; el_id=&#8221;targeted&#8221;][vc_column width=&#8221;1\/3&#8243;][vc_custom_heading text=&#8221;Targeted therapies&#8221; font_container=&#8221;tag:h3|text_align:left&#8221; use_theme_fonts=&#8221;yes&#8221;][\/vc_column][vc_column width=&#8221;2\/3&#8243;][vc_column_text]<\/p>\n<h4>Personalized cancer treatment<\/h4>\n<p>The development of revolutionary targeted therapies marked the beginning of a new era of personalized medicine for melanoma patients, allowing tumors to be treated with minimal damage to healthy cells.<\/p>\n<p>Targeted therapies use drugs and other agents to attack melanoma by inhibiting the action of defective genes and molecules \u2013 including BRAF and MEK \u2013 that play a role in accelerating the growth and spread of melanoma cells. When successful, these treatments halt or slow the progression of the disease and help patients live longer.<\/p>\n<p>In the past decade there has been notable success using BRAF- and MEK-targeted therapies to treat advanced melanoma.<\/p>\n<h4>What is BRAF?<\/h4>\n<p>BRAF is known as a \u201cswitch gene.\u201d It produces a protein that normally regulates skin cells, allowing them to multiply only when needed. But genetic changes (mutations) to BRAF can keep it switched on abnormally, driving out-of-control tumor growth.<\/p>\n<p>About half of all melanoma patients have the BRAF mutation. Targeted therapies have had significant success in improving outcomes for patients with advanced melanoma who have the BRAF mutation.<\/p>\n<h4>BRAF inhibitors<\/h4>\n<h5>Treatment Overview<\/h5>\n<p>In 2011, vermurafenib became the first targeted therapy approved for advanced melanoma patients. For varying amounts of time, it shut off the BRAF gene&#8217;s production of the BRAF protein.<\/p>\n<h5>Approved Medications<\/h5>\n<p><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#vemurafenib\">Vemurafenib (Zelboraf\u00ae)<\/a><br \/>\n<a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#dabrafenib\">Dabrafenib (Tafinlar<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#vemurafenib\">\u00ae<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#dabrafenib\">)<\/a><br \/>\n<a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#encorafenib-binimetinib\">Encorafenib (Braftovi<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#vemurafenib\">\u00ae<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#encorafenib-binimetinib\">)<\/a><\/p>\n<h5>How they work<\/h5>\n<p>These targeted drugs interrupt and deactivate the tumor growth pathway driven by the genetic change in BRAF, delaying the progression of the disease, shrinking tumors and extending the life of patients.<\/p>\n<p>If testing confirms that a patient has advanced melanoma, the lab will generally perform a BRAF mutation test to determine whether the tumor has the defective gene. These results show whether therapies targeting BRAF can be used in treatment.[\/vc_column_text][vc_row_inner][vc_column_inner][vc_column_text el_class=&#8221;callout&#8221;]<\/p>\n<p style=\"text-align: center;\">What is MEK?<\/p>\n<p style=\"text-align: center;\">MEK is an enzyme that works together with BRAF to regulate cell growth. Drugs that inhibit\u00a0MEK\u00a0can\u00a0also help treat melanomas that arise because of mutations in the BRAF\u00a0gene.<\/p>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner css=&#8221;.vc_custom_1559576708372{margin-top: 2em !important;}&#8221;][vc_column_inner][vc_column_text]<\/p>\n<h4>MEK inhibitors<\/h4>\n<h5>Treatment Overview<\/h5>\n<p>BRAF-targeted therapies are often remarkably effective for a period of time, but in most patients, the melanoma eventually develops a resistance to treatment and begins to grow again. Medications targeting MEK were developed to address this resistance and halt the advancement of the disease.<\/p>\n<h5>Approved Medications<\/h5>\n<p><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/\">Trametinib (Mekinist\u00ae<\/a>)<br \/>\n<a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/\">Cobimetinib (Cotellic\u00ae<\/a>)<br \/>\n<a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/\">Binimetinib (Mektovi<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/\">\u00ae<\/a>)<\/p>\n<h5>How they work<\/h5>\n<p>To delay melanoma treatment resistance and increase survival, researchers developed targeted drugs that inhibit MEK.<\/p>\n<h4>Combination targeted therapies<\/h4>\n<p><em>Better health outcomes by pairing therapies<\/em><\/p>\n<h5>Treatment Overview<\/h5>\n<p>A melanoma patient with defective BRAF who goes on targeted therapy will almost always be treated with drugs that inhibit both BRAF and MEK, because pairing these targeted drugs has been found to work better than the BRAF therapies alone. Patients treated with combination therapies have faster, more dramatic and sustained tumor shrinkage, slower disease progression and live longer on average, while also experiencing fewer serious side effects. The combos work so effectively that the use of the single-drug targeted therapies has been virtually eliminated.<\/p>\n<h5>Approved Medications<\/h5>\n<p><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#dabrafenib-trametinib\">Dabrafenib-Trametinib (Tafinlar<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#dabrafenib-trametinib\">\u00ae<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#dabrafenib-trametinib\">-Mekinist\u00ae)<\/a><br \/>\n<a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#encorafenib-binimetinib\">Encorafenib-Binimetinib (Braftovi<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#dabrafenib-trametinib\">\u00ae<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#encorafenib-binimetinib\">-Mektovi<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#dabrafenib-trametinib\">\u00ae<\/a><a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#encorafenib-binimetinib\">)<\/a><br \/>\n<a href=\"http:\/\/skincancer.org\/treatment-resources\/treatment-glossary\/#vemurafenib-cobimetinib\">Cobimetinib-Vemurafenib (Cotellic\u00ae-Zelboraf\u00ae)<\/a><\/p>\n<h5>How they work<\/h5>\n<p>The principle behind combination therapy is that even when the BRAF inhibitor meets with resistance, the MEK inhibitor can be effective in slowing or stopping disease progression.<\/p>\n<p>*<strong>Learn more<\/strong> about the\u00a0<strong>combination immunotherapy and<\/strong> <strong>targeted therapy: <\/strong><a href=\"https:\/\/www.skincancer.org\/treatment-resources\/treatment-glossary\/#1599190444913-082c481a-33e4\">Atezolizumab-Cobimetinib-Vemurafenib<\/a> (Tecentriq\u00ae-Cotellic\u00ae-Zelboraf\u00ae).[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row el_class=&#8221;content-block&#8221; el_id=&#8221;chemotherapy&#8221;][vc_column width=&#8221;1\/3&#8243;][vc_custom_heading text=&#8221;Chemotherapy&#8221; font_container=&#8221;tag:h3|text_align:left&#8221; use_theme_fonts=&#8221;yes&#8221;][\/vc_column][vc_column width=&#8221;2\/3&#8243;][vc_column_text]<\/p>\n<h5>Treatment Overview<\/h5>\n<p>Since immunotherapies and targeted therapies produce vastly superior results, chemotherapy is no longer a frontline therapy. It is most often used if targeted therapies and\/or checkpoint blockade therapies fail. It may sometimes be used in conjunction with these other therapies.<\/p>\n<h5>Approved Medications<\/h5>\n<p>Dacarbazine (DTIC)<br \/>\nTemozolomide<\/p>\n<h5>How it works<\/h5>\n<p>Chemotherapy is a systemic approach to stopping tumor growth using certain medicines that either kill cancer cells or stop them from multiplying. It has never been proven to extend life for melanoma patients as a single therapy, however, and can have serious side effects.[\/vc_column_text][\/vc_column][\/vc_row][vc_row el_class=&#8221;content-block&#8221; el_id=&#8221;radiation&#8221;][vc_column width=&#8221;1\/3&#8243;][vc_custom_heading text=&#8221;Radiation therapy&#8221; font_container=&#8221;tag:h3|text_align:left&#8221; use_theme_fonts=&#8221;yes&#8221;][\/vc_column][vc_column width=&#8221;2\/3&#8243;][vc_column_text]<\/p>\n<h5>Treatment Overview<\/h5>\n<p>Radiation is rarely used to treat a primary melanoma tumor, but may be used to treat melanomas that have spread to the brain or other distant sites to shrink tumors and decrease pain, improve comfort and mobility. It can also be used on the surgical site after surgery to help assure that all tumor cells have been killed, and is being studied in combination with treatments such as checkpoint blockade therapies to enhance outcomes.<\/p>\n<h5>How it works<\/h5>\n<p>Radiation is a localized treatment that directs high-energy X-ray beams to penetrate and destroy the tumors or keep them from growing. Radiation is most often used for:<\/p>\n<ul>\n<li>Melanomas at high risk of recurrence: Radiation can be used after surgery to lower the chance of recurrence after removal of certain types of melanomas.<\/li>\n<li>Melanomas that have returned: If the melanoma has come back on the skin or lymph nodes, in certain cases, doctors may treat with radiation to reduce or eliminate the tumor and potentially prevent spread to distant sites.<\/li>\n<li>Melanomas that have spread:\u00a0 Radiation may be used to help make checkpoint blockade therapies or targeted therapies work more effectively.<\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row el_class=&#8221;content-block&#8221; el_id=&#8221;clinical&#8221;][vc_column width=&#8221;1\/3&#8243;][vc_custom_heading text=&#8221;Clinical trials&#8221; font_container=&#8221;tag:h3|text_align:left&#8221; use_theme_fonts=&#8221;yes&#8221;][\/vc_column][vc_column width=&#8221;2\/3&#8243;][vc_column_text]If you have been diagnosed with advanced melanoma, you may be eligible to participate in a clinical trial \u2013 a carefully controlled research study using new or experimental treatments.<\/p>\n<p>Before making a decision, it\u2019s important to discuss the possibilities, risks and benefits of clinical trials with your doctor. For more information about clinical trials that are being conducted now, along with results of recent trials, visit the <a href=\"https:\/\/www.nih.gov\/health-information\/nih-clinical-research-trials-you\/finding-clinical-trial\">Find Studies<\/a> page on the U.S. National Institutes of Health website.[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=&#8221;&#8221;]<em><strong>Reviewed by:<\/strong><br \/>\nAllan C. Halpern, MD<br \/>\n<\/em><em> Ashfaq A. Marghoob, MD<br \/>\n<\/em><em>Ofer Reiter, MD<br \/>\n<\/em><\/p>\n<p><b>Note:<\/b>\u00a0The information included on this website is medically reviewed and factually accurate. It is intended for educational purposes only. The treatment information on this page is not a recommendation or endorsement of any drug, device or treatment, nor does it suggest that any drug, device or treatment is safe or effective for you. If you have any questions about skin cancer treatments, please talk to your health care provider.[\/vc_column_text][\/vc_column][\/vc_row][\/vc_section][vc_row el_class=&#8221;spons-row&#8221;][vc_column][vc_column_text]<\/p>\n<p style=\"text-align: center;\">This section made possible through an education grant from<\/p>\n<p>[\/vc_column_text][vc_column_text css=&#8221;&#8221;]<\/p>\n<div style=\"display: flex; justify-content: center; flex-direction: row;\">\n<p><a class=\"sponsor-logo\" href=\"https:\/\/castlebiosciences.com\/melanomatest\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-6851 size-full\" src=\"https:\/\/www.skincancer.org\/wp-content\/uploads\/CastleLogoColor_Transparent.png\" alt=\"Castle Biosciences Logo\" width=\"2142\" height=\"629\" srcset=\"https:\/\/www.skincancer.org\/wp-content\/uploads\/CastleLogoColor_Transparent.png 2142w, https:\/\/www.skincancer.org\/wp-content\/uploads\/CastleLogoColor_Transparent-600x176.png 600w, https:\/\/www.skincancer.org\/wp-content\/uploads\/CastleLogoColor_Transparent-1024x301.png 1024w, https:\/\/www.skincancer.org\/wp-content\/uploads\/CastleLogoColor_Transparent-768x226.png 768w, https:\/\/www.skincancer.org\/wp-content\/uploads\/CastleLogoColor_Transparent-1536x451.png 1536w, https:\/\/www.skincancer.org\/wp-content\/uploads\/CastleLogoColor_Transparent-2048x601.png 2048w\" sizes=\"auto, (max-width: 2142px) 100vw, 2142px\" \/><\/a><\/p>\n<p><a class=\"sponsor-logo\"><br \/>\n<img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-8852\" src=\"https:\/\/www.skincancer.org\/wp-content\/uploads\/02852_Merck_Logo_Horizontal_TealGrey_CMYK-3.jpg\" alt=\"merck logo\" width=\"577\" height=\"178\" \/><br \/>\n<\/a><\/p>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_section][vc_row][vc_column][vc_column_text] Melanoma\u00a0Treatment [\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column offset=&#8221;vc_col-lg-offset-1 vc_col-lg-10&#8243;][vc_custom_heading text=&#8221;Historic Progress. New Options. More Hope.&#8221; font_container=&#8221;tag:h2|text_align:center&#8221; use_theme_fonts=&#8221;yes&#8221;][\/vc_column][\/vc_row][\/vc_section][vc_section][vc_row][vc_column width=&#8221;9\/12&#8243;][vc_column_text el_class=&#8221;large&#8221;]While melanoma is one of the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":6866,"parent":180,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-2093","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.3 (Yoast SEO v25.3) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Melanoma Treatment - The Skin Cancer Foundation<\/title>\n<meta name=\"description\" content=\"Melanoma treatment options are improving patient survival rates. 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