A Legacy of Immunotherapy Advancements
For over 40 years, the Saint John’s Cancer Institute has been at the forefront of research into how tumors interact with the immune system. Co-founder Donald L. Morton, MD, was a pioneer in this field, developing methods to harness the immune system’s power to combat cancer. In the early 1970s, Dr. Morton successfully used Bacilli Calmette-Guérin (BCG), a weakened strain of the tuberculosis bacterium, to treat melanoma tumors, marking the first successful use of immunotherapy against metastatic human cancer. Combined with the exceptional quality of Saint John’s medical staff and hospital, a unique community-based cancer research and training institute excelling in cancer treatment approaches including surgical oncology, immunotherapy, chemotherapy, and radiation.
Immunotherapy for Melanoma Cancer
Immunotherapy is transforming how melanoma and other cancers are managed. Unlike conventional treatments such as chemotherapy and radiation, immunotherapy works by harnessing the body’s natural defenses to fight melanoma that may have spread in other parts of the body. This revolutionary method helps the immune system identify cancer cells that typically go undetected because they resemble healthy tissue.
How Immunotherapy Works Against Advanced Melanoma
Mechanisms of Action
Immunotherapy drugs activate specific molecules on immune cells, sparking a targeted immune response. These treatments help the immune system outsmart cancer’s defenses, making it possible to destroy cancer cells more effectively.
Key Immunotherapy Strategies
- Immune Checkpoint Inhibitors: These drugs block proteins that prevent immune cells from attacking cancer cells. By inhibiting these checkpoints, the immune system can recognize and destroy cancer cells more effectively
- T-cell Transfer Therapy: This involves extracting immune cells from the patient, enhancing their cancer-fighting abilities in a lab, and reintroducing them into the body
- Monoclonal Antibodies: Lab-created antibodies that bind to specific targets on cancer cells, marking them for destruction by the immune system
Expected Outcomes
Expected Outcomes of Immunotherapy
Improved Survival and Remission
- Improved Survival Rates: Patients receiving immunotherapy often experience more prolonged survival compared to those undergoing conventional treatments
- Durable Responses: Unlike chemotherapy, which may only provide temporary relief, immunotherapy can lead to long-lasting remission
- Reduced Tumor Size: Immunotherapy can shrink tumors by enabling the immune system to target and kill cancer cells effectively
Side Effects of Immunotherapy
While immunotherapy is generally well-tolerated, it can cause side effects, some of which may be significant:
Common Side Effects
- Fatigue
- Skin rashes
- Diarrhea
- Nausea
- Decreased thyroid hormone levels
Inflammation Risks
Heightened immune activity can lead to inflammation in various organs, such as the lungs (causing cough or shortness of breath), liver (elevated liver enzymes), and thyroid (altered hormone levels).
Rare Occurrences
sSevere allergic reactions or inflammation-related in responses can occur but are uncommon. Regular monitoring and communication with a healthcare provider are essential during treatment.
Types of Immunotherapies for Cancer of Melanoma
TLA-4 Inhibitors
In 2011, the FDA approved ipilimumab, a drug that targets the CTLA-4 protein. This checkpoint molecule acts as an “off switch” for T cells, preventing them from attacking healthy cells but also blocking them from attacking tumors. Ipilimumab has been shown to extend survival in patients with metastatic melanoma, with more than 20% of patients alive three years after treatment.
PD-1 and PD-L1 Inhibitors
Pembrolizumab and nivolumab are drugs that target PD-1 and PD-L1 proteins, which also act as immune system brakes. Pembrolizumab has produced responses in approximately one-third of patients.
Intra-Tumoral Immunotherapy
This promising approach involves directly injection into tumors, concentrating the treatment at the site of cancer while minimizing side effects. Investigational therapies include oncolytic viruses, gene therapies, and vaccine adjuvants.
New Treatments and Melanoma Clinical Research Guidelines
Recent advancements in melanoma treatment include the approval of tumor-infiltrating lymphocyte (TIL) therapy, which amplifies the cancer-fighting immune cells already present in a patient’s melanoma.
Lifileucel, the first TIL therapy approved for clinical use, has shown promise in extending survival for patients with metastatic melanoma.
Additionally, new guidelines emphasize the importance of accurate staging and personalized treatment plans, incorporating sentinel lymph node biopsy and advanced imaging techniques.
Support and Personalized Cancer Care at Saint John’s
Saint John’s Health Center offers multidisciplinary care bringing together surgeons, oncologists, radiologists, and other specialists to create personalized treatment strategies. Participation in tumor boards ensures that each case receives a thorough, expert-level review.
Whether you’re looking for expert opinions or want to explore clinical trials tailored to your melanoma profile, we’re here to help. Your health and well-being are our top priorities.
If you have questions regarding immunotherapy for melanoma, please call today or click here to schedule an appointment or for an expert second opinion.
