Advancements in Targeted Therapy for Melanoma: Successes and Future Prospects

By Dr. Sajjan Rajpurohit in Cancer Centre

Mar 28 , 2023 | 2 min read

Melanoma, a severe form of skin cancer, originates in melanocytes—the cells responsible for skin pigmentation. It remains one of the deadliest skin cancers, primarily due to its high metastatic potential and poor prognosis in advanced stages. While traditional treatments like chemotherapy and radiation therapy have shown limited success, targeted therapy for melanoma has emerged as a promising alternative, revolutionizing patient outcomes.

What is Targeted Therapy?

Targeted therapy is a specialized cancer treatment designed to attack specific molecules or pathways that contribute to cancer growth and spread. Unlike chemotherapy, which affects all rapidly dividing cells, targeted therapies specifically focus on cancer cells, reducing damage to healthy cells. These therapies can be administered orally, intravenously, or via injection, and they function by:

Inhibiting cell division.
Blocking cancer-promoting proteins.
Preventing tumor growth and metastasis.

Types of Targeted Therapy for Melanoma Skin Cancer

Targeted therapies have transformed melanoma treatment by offering tailored approaches based on genetic and molecular profiles. Key advancements include:

1. BRAF Inhibitors

Key Drugs: Vemurafenib, Dabrafenib
Mechanism: Block the mutated BRAF protein found in ~50% of melanomas.
Benefits: Improved response rates and extended survival in advanced melanoma cases.

2. MEK Inhibitors

Key Drugs: Trametinib, Cobimetinib
Mechanism: Target MEK, a downstream effector of the BRAF pathway.
Usage: Often combined with BRAF inhibitors for enhanced effectiveness.

3. KIT Inhibitors

Key Drugs: Imatinib, Dasatinib
Mechanism: Inhibit the KIT protein, commonly mutated in specific melanoma subtypes.

4. Checkpoint Inhibitors

Key Drugs: Ipilimumab, Nivolumab
Mechanism: Stimulate the immune system to recognize and destroy cancer cells.
Benefits: Improved survival rates for advanced melanoma.

Targeted Therapy for Rare Melanoma Types

Mucosal Melanoma

This rare and aggressive melanoma occurs in mucous membranes (e.g., nasal passages, mouth, genital tract) and has limited treatment options.

Challenges: Low prevalence of BRAF mutations.
Therapy Focus: Drugs like Imatinib target c-KIT mutations, showing response rates up to 50% in early studies.

Ocular Melanoma

A rare melanoma affecting the uveal tract of the eye.

Key Mutations: GNAQ, GNA11.
Therapy Focus: Drugs like Selumetinib and Binimetinib target the MAP kinase pathway, achieving response rates of 40-50%.

Combining Targeted Therapy with Other Treatments

Targeted therapy often works best in combination with other treatments to improve outcomes and reduce drug resistance.

Immunotherapy

Mechanism: Activates the immune system to fight cancer cells.
Synergy: Combining targeted therapy with checkpoint inhibitors (e.g., Nivolumab) enhances survival rates.

Radiation Therapy

Traditional Role: Treats localized melanoma.
Emerging Role: Combined with targeted therapies, it delays resistance and improves response rates.

Future Prospects in Melanoma Targeted Therapy

Ongoing research aims to:

Develop therapies targeting additional mutations.
Personalize treatments based on individual genetic profiles.
Combine therapies to overcome resistance and improve survival rates.

If you're wondering what is an oncologist, they are experts in diagnosing and treating cancer.

Frequently Asked Questions

1. How Long Does Targeted Melanoma Therapy Take?

The duration varies based on the treatment type, cancer stage, and patient response. It can range from a few months to long-term maintenance.

2. What are The Side Effects of Targeted Therapy for Melanoma?

Common side effects include:

Fatigue
Nausea and vomiting
Diarrhea
Skin rash
High blood pressure
Liver issues

3. How Much Does Targeted Therapy Cost?

Costs depend on the treatment, duration, and insurance coverage. Many pharmaceutical companies offer financial assistance programs.

4. Who is a Candidate for Targeted Therapy?

Patients with specific genetic mutations (e.g., BRAF, NRAS) or advanced melanoma unresponsive to other treatments are ideal candidates. Oncologists determine suitability based on individual profiles.