Melanoma medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Medical Therapy

Although the mainstay of therapy for melanoma is surgical excision, chemotherapy is indicated for high risk melanomas as adjuvant therapy (stages > IIA) and for metastatic disease as first-line therapy. Several single agent and combination regimens have been studied, all with modest impact on survival. All current guidelines still recommend enrollment in clinical trials over current available regimens for patients with metastatic disease. Below is a summary of available adjuvant and treatment regimens. The only agents recommended for adjuvant therapy are inteferons.

Chemotherapy regimens

Adjuvant therapy[1]

  1. Interferon alfa-2a (Roferon-A)
  2. Interferon alfa-2b (Intron-A)
  3. Peginterferon alfa-2b (Sylatron)

Metastatic or unresectable disease[1]

  • Single Agent Chemotherapy
  1. Dabrafenib (Tafinlar)
  2. Dacarbazine (DTIC)
  3. Docetaxel (Taxotere)
  4. High-dose (HD) IL-2
  5. IL-2 maintenance biotherapy
  6. Imatinib (Gleevec)
  7. Ipilimumab (Yervoy)
  8. Nivolumab (Opdivo)
  9. Paclitaxel (Taxol)
  10. Pembrolizumab (Keytruda)
  11. Temozolomide (Temodar)
  12. Trametinib (Mekinist)
  13. Vemurafenib (Zelboraf)
  • Combination Chemotherapy
  1. Paclitaxel nanoparticle albumin-bound + Bevacizumab + Carboplatin (ABC)
  2. Carboplatin + Paclitaxel (CP)
  3. Carboplatin + Paclitaxel + nanoparticle albumin-bound
  4. Carboplatin + Paclitaxe +, Sorafenib
  5. Cisplatin + Dacarbazine ± Carmustine
  6. Cisplatin + Dacarbazine + IL-2 + IFN alfa-2b ± Carmustine
  7. Cisplatin + Paclitaxel + Dacarbazine
  8. Cisplatin + Vinblastine + Dacarbazine (CVD)
  9. CVD + IL-2 + IFN alfa-2b (sequential biochemotherapy)
  10. Temozolomide + Bevacizumab (TB)
  11. Dabrafenib + Trametinib
  12. Ipilimumab + Dacarbazine
  13. Ipilimumab + Nivolumab

References

  1. 1.0 1.1 Peter Yang and Jeremy Warner. Melanoma. Hemonc.org. Accessed on August 21, 2015. http://hemonc.org/wiki/Melanoma