Stage four melanoma, although the most life threatening, offers the most treatment options. Whereas, stage 1 and 2 are cured by simple outpatient surgery, and stage 3 is watched similarly, stage four treatments are being studied in many clinical trials.

Chemotherapy and Biological Therapies
Although chemotherapy sometimes produces dramatic regression of disseminated melanoma, it only rarely results in long-term survival. Indeed, in a recent review of chemotherapy for cancer in advanced stages, melanoma patients were classed with those who could expect only "minor response—no demonstrable prolongation of survival" from chemotherapy.

New therapies that stimulate the immune system to at­tack melanoma or that choke off the specialized blood vessels supplying metastases may offer effective therapy in the future. For example, anti-CTLA 4, or Ipilimumab is a human monoclonal antibody which targets certain cells in the body by attaching themselves to those molecules. This causes some cancer cells to die and makes others more likely to be killed by other therapies. Ipilimumab is a more general immune booster. It blocks a protein called CTLA-4 that acts as a brake on T cells, the soldiers of the immune system

 Vaccines and immunological hormones called cytokines — offer hope for melanoma treatment. It now seems that in a few patients, disease may actually melt away, after it has been treated with interleukin-2, but this is in less than 8% of patients with much associated toxicity.

 

Another promising therapy lies in the BRAF studies. Most melanoma tumors grow because of a genetic mutation in a gene called the BRAF.  Many researchers believe that if BRAF pathway can be blocked, the melanoma would stop growing. There are drugs being formulated to block BRAF.  Low toxicity is also associated with the developments and we can hope that this year (2010) will bring some promising developments along these lines.

There are many clinical trials to explore and our hotline can help match you to a treatment trial if that is what you choose to do.  You can also go to:  www.clinicaltrials.gov and put melanoma in the search for a list of trials.

SOURCE: Poole, Catherine, Guerry, DuPont, M.D.,  Melanoma Prevention Detection and Treatment, New Haven:  Yale University Press, 2005.  

UPDATE: March 10, 2010

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