Melanoma

Doctors are working to learn more about melanoma, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trial. Always talk with your doctor about the diagnostic and treatment options best for you.

Enhanced prevention and early detection methods. There is ongoing research on better prevention and early detection strategies for melanoma. Both primary prevention (keeping melanoma from developing) and secondary prevention (early detection of melanoma) are important. One promising area is the screening of people with a high risk of developing melanoma.

Targeted therapy. As discussed in the Treatment section, targeted therapy is a treatment that targets specific genes or proteins. It is a major area of research for melanoma. Ongoing research has identified a number of molecular pathways and activated or mutated genes in melanoma. This includes the most commonly mutated gene BRAFas well as activation of the MAP kinase pathway. Ongoing laboratory and clinical research confirms the importance of these genes and pathways in melanoma.

There are several drugs being researched that target BRAF and the MAP kinase pathway. This includes BRAF inhibitors (such as the recently approved vemurafenib; see Treatment), GSK BRAF inhibitors, and MEK inhibitors. There are many ongoing clinical trials exploring these new approaches in phase I, phase II, and phase III clinical trials. Ongoing clinical trials are evaluating the optimum dose and schedule and combining targeted therapies with other pathway inhibitors, as well as combining these therapies with immunotherapy. Other studies will be focused on the development of new drugs which target the AKT/PI3K pathway. Another important focus is the development of agents which target the C-kit gene, which is mutated or associated with extra copies of the gene in certain subtypes of melanoma including lentigo maligna melanoma, mucosal melanoma, and acral lentiginous melanoma (melanoma of the palms, soles, and nail beds).

In summary, recent advances in medical understanding of the genetic abnormalities that occur in melanoma will allow for the selection of tailored and targeted treatment that matches the patient's type/subtype of melanoma.

Immunotherapy. Immunotherapy, in which the immune system is activated to fight cancer, is also a major focus in melanoma research. Ongoing clinical trials are evaluating several different approaches, including those discussed in Treatment.

Currently, melanoma peptide vaccines are being intensely evaluated in clinical trials for patients with both localized and advanced melanoma. Research has shown that vaccination can cause the immune system to fight melanoma, even in advanced disease, but these therapies are still considered experimental. The vaccines are made using certain proteins found only on a melanoma tumor and are given as an injection; the person's immune system then recognizes the proteins and destroys melanoma cancer cells. Learn more about vaccines.

In addition, as explained in the Treatment section, ipiluminab is a promising new immunotherapy for the treatment of patients with melanoma.

Ipiluminab is a monoclonal antibody directed against CTLA-4 (cytotoxic T-lymphocyte associated molecule-4). This new approach works by taking the brakes off the immune system. Ongoing clinical trials of ipiluminab will provide further guidance regarding the role of this drug in the treatment of patients with melanoma. This medicine does have unique side effects. Because it activates the immune system, it can trigger “autoimmune” side effects in which the patient's own immune system attacks normal cells in their body. Patients are monitored closely for diarrhea and other side effects.

Another type of experimental immunotherapy involves altering the patient's lymphocytes (white blood cells) in the laboratory to increase their ability to fight the tumor. The changed cells are given back to the patient, often in combination with chemotherapy. These types of treatments are known as adoptive cell transfer (ACT).

Chemotherapy. There are several new types of chemotherapy and combinations of drugs being evaluated in clinical trials. In addition, the combination of chemotherapy and anti-angiogenesis inhibitors (substances that prevent the formation of new blood vessels that tumors need to grow and spread) or immunotherapy is also being explored. In addition, the combination of chemotherapy and drugs that may alter melanoma resistance to chemotherapy drugs are currently being explored.

Gene therapy. Gene therapy is a targeted form of treatment that is able to change bits of genetic code in a person's cells. Although gene therapy is relatively new, it shows potential for treating melanoma. Although there are several approaches to gene therapy, one goal is to make the cancer cells "look" different, so the immune system can recognize them as cancer and attack them.

Supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current melanoma treatments in order to improve patients' comfort and quality of life.

Learn more about common statistical terms used in cancer research.

Looking for More about Current Research?

If you would like additional information about the latest areas of research regarding melanoma, explore these related items:

• To find clinical trials specific to your diagnosis, talk with your doctor or search online clinical trial databases now.
• Review research announced at ASCO's recent scientific meetings.
• Read ASCO's latest Clinical Cancer Advances report (PDF), which highlights top research findings over the past year.
• Visit ASCO's CancerProgress.Net website to learn more about the historical pace of research for melanoma.

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