Targeted Therapy for Melanoma

At Saint John’s Health Center in Santa Monica, CA, we adopt a multidisciplinary approach to care, involving specialists across various disciplines. These experts participate in cancer tumor boards, where they evaluate and discuss each case in detail. This collaborative effort ensures that every patient receives a comprehensive and personalized treatment plan, leveraging the collective expertise of surgeons, oncologists, radiologists, and other healthcare professionals.

Targeted therapy for melanoma represents a promising approach to treating this aggressive form of skin cancer. These therapies are designed to specifically target molecular changes within melanoma tumor cells, offering a more precise treatment option compared to traditional chemotherapy.

BRAF/MEK Inhibitors

One of the most common targets for melanoma treatment is the BRAF gene. About half of all melanomas have mutations in the BRAF gene, which leads to uncontrolled cell growth. BRAF inhibitors, such as vemurafenib (Zelboraf), dabrafenib (Tafinlar), and encorafenib (Braftovi), are designed to block the activity of the mutated BRAF protein, thereby slowing down or stopping the growth of cancer cells. These drugs are often used in combination with MEK inhibitors, like trametinib (Mekinist), cobimetinib (Cotellic), and binimetinib (Mektovi), which target the MEK protein that works closely with BRAF. Combining BRAF and MEK inhibitors has been shown to be more effective than using either drug alone, as it helps to prevent the cancer cells from developing resistance to treatment.

C-kit Inhibitors

C-kit mutations are less common in melanoma but can be found in specific subtypes such as mucosal and acral lentiginous melanomas. C-kit inhibitors, like imatinib (Gleevec), sunitinib (Sutent), and regorafenib (Stivarga), are used to block the activity of the c-KIT protein, which is involved in cell growth and survival. These drugs have shown promising results in treating gastrointestinal stromal tumors (GISTs) and are currently being studied for their effectiveness in melanoma.

Usage and Side Effects

Targeted therapies for melanoma are typically administered as oral pills, making them more convenient than traditional chemotherapy. They are used in metastatic Stage IV melanoma and have recently been approved for use as adjuvant therapy in Stage III melanoma after surgery. Unlike standard cytotoxic chemotherapy, which targets all rapidly dividing cells, targeted therapies focus specifically on cancer cells, leading to a different set of side effects. Common side effects of BRAF inhibitors include skin thickening, rash, itching, sun sensitivity, headache, fever, joint pain, fatigue, hair loss, and nausea. MEK inhibitors can cause similar side effects, along with potential heart rhythm issues and kidney problems. C-kit inhibitors may cause stomach upset, diarrhea, muscle pain, and skin rashes.

Challenges and Future Directions

Despite the rapid responses seen with BRAF inhibitors, many patients experience limited durability due to the emergence of acquired drug resistance. Researchers are continually working to develop new strategies to overcome this resistance and improve the effectiveness of targeted therapies. The use of c-kit inhibitors in melanoma is still being studied, and ongoing clinical trials aim to understand their potential benefits and limitations better.

Targeted therapy offers a tailored approach to treating melanoma by focusing on specific genetic mutations within the tumor cells. While these treatments come with their own set of challenges and side effects, they represent a significant advancement in the fight against melanoma, offering hope for improved outcomes and a better quality of life for patients.

Contact the Saint John’s Health Center

The experts at Saint John’s Health Center and researchers of the Saint John’s Cancer Institute are ready to support you and help you navigate through this challenging time. Whether you are looking for an expert second opinion, a better understanding of your health situation, or access to personalized clinical trials, please reach out to us by calling 310-829-8317 or using our melanoma contact form. We are committed to providing you with the best possible care and outcomes.