Update on systemic therapy for advanced cutaneous melanoma and recent development of novel drugs

Clin Exp Metastasis. 2018 Aug;35(5-6):503-520. doi: 10.1007/s10585-018-9913-y. Epub 2018 Jul 17.

Abstract

Malignant melanoma is generally chemo- and radio-resistant, and patients with advanced melanoma have a poor prognosis. However, with our increased understanding of the checkpoint immune molecules and genetic alterations of melanoma cells, more effective immunotherapy, such as anti CTLA4 antibody and anti PD-1 antibodies, and targeted drug therapy, such as BRAF inhibitors and MEK inhibitors, have been developed, resulting in improved overall survival and quality of life of patients with advanced melanoma. In addition, emerging technologies to develop prognostic and predictive biomarkers for response to systemic therapy could help clinicians make more accurate assessments of the disease and formulate more effective treatment plans. In this review, current standard systemic therapy options and recently developed novel drugs for advanced melanoma are discussed.

Keywords: BRAF mutation; CTLA-4; Checkpoint inhibitor; Melanoma; PD-1; Targeted therapy.

Publication types

  • Review

MeSH terms

  • CTLA-4 Antigen / antagonists & inhibitors
  • CTLA-4 Antigen / immunology
  • Humans
  • Immunotherapy / trends*
  • MAP Kinase Kinase Kinase 1 / antagonists & inhibitors
  • Melanoma / immunology
  • Melanoma / pathology
  • Melanoma / therapy*
  • Melanoma, Cutaneous Malignant
  • Molecular Targeted Therapy*
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors
  • Programmed Cell Death 1 Receptor / immunology
  • Protein Kinase Inhibitors / immunology*
  • Protein Kinase Inhibitors / therapeutic use
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*
  • Treatment Outcome

Substances

  • CTLA-4 Antigen
  • CTLA4 protein, human
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Protein Kinase Inhibitors
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • MAP Kinase Kinase Kinase 1