In Some Melanoma Tumors, There are Specific Changes in the Tumor Cells That Allow for a More Targeted Treatment.
These innovative therapies are designed to take advantage of the molecular changes that can occur within melanoma tumor cells. Treatment may include:
- BRAF/MEK inhibitors
- C-kit inhibitors
This therapy is used in metastatic, Stage IV disease and recently has been approved to be given in some patients after surgery (adjuvant therapy in Stage III). It is an oral pill and has a different set of side effects than standard cytotoxic chemotherapy, which basically targets all dividing cells. The MEK gene is closely related to the BRAF gene and therapy is more effective when given in combination. Despite rapid responses from BRAF inhibitors, durability in the majority is limited by the emergence of acquired drug resistance.
C-kit mutations are much less common mutations but treatment to inhibit their activity can be used. These mutations can be seen in mucosal and acral lentiginous melanomas. Drugs targeting this gene in other tumors, like gastrointestinal stromal tumors (GIST), has shown excellent responses and the use in melanoma is currently being studied and used in select cases.