Being Well

Treating Melanoma Skin Cancer With Advancements With Immunotherapy

Craig L. Slingluff, MD, a leading melanoma skin cancer researcher and professor of surgery at UVA Cancer Center, points out that everyone is at risk of developing melanoma. While scary, the disease can be prevented and treated. Call your doctor if you find any moles or spots on your skin that look different from others or that are growing or bleeding.

Melanoma, while being the deadliest form of skin cancer, is treatable. The Centers for Disease Control and Prevention (CDC) estimates that more than 90 percent of U.S. melanoma cases are caused by the ultraviolet radiation that comes with sun exposure. According to the CDC, 9,000 Americans die each year from melanoma skin cancer. The death rate from melanoma, however, is predicted to remain stable. That’s because melanoma treatments have improved dramatically during the past 30 years.

Despite these advances, early detection remains important. Here’s when you should see a doctor and ways melanoma is being treated.

The Warning Signs

According to the American Academy of Dermatology, you should watch out for the ABCDEs in your moles: asymmetrical moles, irregular borders, moles of various colors, large diameters and evolving moles. Craig L. Slingluff, MD, a leading melanoma skin cancer researcher and professor of surgery at UVA Cancer Center, points out that everyone is at risk of developing melanoma.

“See your doctor whenever you find a mole or spot on your skin that looks different than any others, especially any spot that’s growing noticeably or bleeding,” he says. “Melanomas tend to be brown or black in color and usually have variations in color within the mole. But some melanomas don’t have pigmentation, which brings us back to anything that’s growing or changing should be examined promptly.”

Stimulating the Immune System

According to Dr. Slingluff, by the time cancer has developed, the immune system is already fighting it. “The cancer has figured out a way to avoid the immune system or make it less effective,” he explains. “Our goal is to return the immune system to its original state.”

The American Cancer Society defines immunotherapy as the use of medicines to stimulate your immune system to recognize and destroy cancer cells more effectively. Several types of immunotherapy can be used to treat patients with melanoma. One approach is to directly activate your immune system against cancer. This is done using man-made proteins that provide an overall boost to the immune system, according to the American Society of Clinical Oncology (ASCO).

Another approach is to use new anticancer drugs that take the brakes off the immune system while not overstimulating it, says Dr. Slingluff. Checkpoint inhibitors, the general name for these “brake removal” drugs, focus on immune system cells by targeting specific proteins. This stimulates your cells to fight skin cancer.

Two drugs approved by the US Food and Drug Administration (FDA) and known as PD-1 inhibitors are pembrolizumab (Keytruda) and nivolumab (Opdivo), according to the Cancer Research Institute. By blocking PD-1, these drugs boost the immune response against melanoma cancer cells. These drugs are given as an intravenous (IV) infusion every 2 or 3 weeks, as the American Cancer Society describes.

Ipilimumab (Yervoy) also stimulates your immune response, but differently. It blocks the CTLA-4 protein on immune system cells. Additionally, the FDA recently approved giving ipilimumab and nivolumab together after positive, encouraging test results according to the Cancer Research Institute.

A Bright Future

The conventional wisdom is to start melanoma treatment with less aggressive therapies. “Many patients get great results with just one type of treatment,” Dr. Slingluff says. “That’s always a plus because it reduces the chance of someone experiencing unpleasant or harmful side effects.”

The checkpoint inhibitor drugs won’t work on every patient, “but when they do work, those benefits tend to be long lasting,” he says. “These drugs are changing the way we think about curing advanced solid tumors like melanoma.”

Even with these advancements, it’s still important to take special care of your skin. Check with your doctor if you see any suspicious moles.

UVA Cancer Center conducts leading-edge research on immunotherapy for melanoma.

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Darcy Lewis
Darcy Lewis